{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:56:30Z","timestamp":1787021790953,"version":"build-2736575974"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>In India, and many low-middle income countries (LMICs), emergency medicine (EM) remains a poorly defined specialty and an unregulated field of clinical practice. Recognition of the attitudes, understanding, and expectations of patients presenting to Indian EDs will be crucial to the continued development of EM as a specialty. This is a multicenter, prospective, cross sectional study of adult and pediatric patients presenting to the ED in three geographically distinct regions of India. Participants were surveyed about their expectations regarding the type of care that they expected to receive, previous treatment options they have utilized, basic understanding of ED operations, factors contributing to their decision to seek ED care, and basic demographic information. 779 patients were approached to participate in the study, of which 698 (90%) completed the survey. Common ways that patients reported learning about the ED were referral from another healthcare provider (45%) and recommendation by a family member (61%). Participants chose the ED was because they thought they would be seen quickly (89%), would receive acute pain management (45%), their regular outpatient care was closed (45%), or were sent by another doctor (45%). Patients expected to wait 0.3 hours (18 minutes) on average to see a doctor in the ED. Over 75% or patients expected to see a specialist consultant in the ED and 12% expected to see their personal physician. Eighty-five percent of patients were triaged as moderate or high acuity, and 74% of patients were admitted. This study found that ED in India is utilized by a population with an extremely high acuity of medical illness that attempts to access healthcare through multiple avenues. Patients most frequently visit the ED due to a referral from another healthcare provider or family member. Most patients are aware of the existence of the ED, though understanding of available services may be lacking. Future research should focus on community outreach and education initiatives on ED services.<\/jats:p>","DOI":"10.1371\/journal.pgph.0000009","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T13:22:33Z","timestamp":1644585753000},"page":"e0000009","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Characteristics and expectations among emergency department patients in India"],"prefix":"10.1371","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-4380","authenticated-orcid":true,"given":"Kevin","family":"Davey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9059-3254","authenticated-orcid":true,"given":"Sumin","family":"Jacob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9788-5391","authenticated-orcid":true,"given":"Nilesh","family":"Prasad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1237-7871","authenticated-orcid":true,"given":"Manjula","family":"Shri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-653X","authenticated-orcid":true,"given":"Richard","family":"Amdur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7230-2583","authenticated-orcid":true,"given":"Janice","family":"Blanchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3827-4851","authenticated-orcid":true,"given":"Jeffrey","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4730-571X","authenticated-orcid":true,"given":"Katherine","family":"Douglass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"key":"pgph.0000009.ref001","volume-title":"World Bank. Disease Control Priorities Project. Disease Control Priorities in Developing Countries.","author":"D Jamison","year":"2006"},{"issue":"11","key":"pgph.0000009.ref002","doi-asserted-by":"crossref","first-page":"993","DOI":"10.15171\/ijhpm.2018.55","article-title":"The Making of a New Medical Specialty: A Policy Analysis of the Development of Emergency Medicine in India","volume":"7","author":"V Sriram","year":"2018","journal-title":"International Journal of Health Policy and Management"},{"issue":"3","key":"pgph.0000009.ref003","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ijgo.2013.03.030","article-title":"A systematic review and thematic synthesis of qualitative studies on maternal emergency transport in low-and middle-income countries","volume":"122","author":"A Wilson","year":"2013","journal-title":"Int J Gynecol Obstet"},{"key":"pgph.0000009.ref004","first-page":"626","article-title":"Emergency medical systems in low- and middle-income countries: recommendations for action","volume":"83","author":"O Kobusingye","year":"2005","journal-title":"Bull World Health Organ"},{"key":"pgph.0000009.ref005","doi-asserted-by":"crossref","first-page":"981096","DOI":"10.5402\/2011\/981096","article-title":"Barriers to emergency obstetric care services in perinatal deaths in rural Gambia: a qualitative in-depth interview study.","volume":"2011","author":"A Jammeh","year":"2011","journal-title":"ISRN Obstet Gynecol"},{"key":"pgph.0000009.ref006","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1742-4755-2-3","article-title":"Maternal mortality in the rural Gambia, a qualitative study on access to emergency obstetric car","volume":"2","author":"M Cham","year":"2005","journal-title":"Reprod Health"},{"issue":"Suppl 2","key":"pgph.0000009.ref007","doi-asserted-by":"crossref","first-page":"S356","DOI":"10.1007\/s11524-010-9481-1","article-title":"Barriers to formal emergency obstetric care. services\u2019 utilization","volume":"88","author":"H Essendi","year":"2011","journal-title":"J Urban Health"},{"issue":"5","key":"pgph.0000009.ref008","doi-asserted-by":"crossref","first-page":"e35903","DOI":"10.1371\/journal.pone.0035903","article-title":"Effectiveness of organizational interventions to reduce emergency department utilization: a systematic review","volume":"7","author":"G Flores-Mateo","year":"2012","journal-title":"PloS one"},{"issue":"10","key":"pgph.0000009.ref009","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1111\/acem.12219","article-title":"Non\u2013Emergency Department Interventions to Reduce ED Utilization: A Systematic Review","volume":"20","author":"S Morgan","year":"2013","journal-title":"Acad Emerg Med"},{"issue":"1","key":"pgph.0000009.ref010","first-page":"23","article-title":"Targeting National Emergency Department Overuse: A Case for Primary Care, Financial Incentives, and Community Awareness","volume":"14","author":"C Nguyen","year":"2014","journal-title":"Harvard Health Policy Rev"},{"issue":"12","key":"pgph.0000009.ref011","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1097\/00005650-199612000-00002","article-title":"Care-seeking patterns of inner-city families using an emergency room: a three-decade comparison.","volume":"34","author":"D Shah-Canning","year":"1996","journal-title":"Med Care"},{"issue":"5","key":"pgph.0000009.ref012","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S0196-0644(98)70033-2","article-title":"An analysis of frequent users of emergency care at an urban university hospital","volume":"32","author":"R. Lucas","year":"1998","journal-title":"Ann Emerg Med"},{"key":"pgph.0000009.ref013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.annemergmed.2005.12.030","article-title":"Characteristics of frequent users of emergency departments","volume":"48","author":"K Hunt","year":"2006","journal-title":"Ann Emerg Med"},{"issue":"1","key":"pgph.0000009.ref014","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1186\/s12913-016-1935-z","article-title":"Motives for self-referral to the emergency department: a systematic review of the literature","volume":"16","author":"N Kraaijvanger","year":"2016","journal-title":"BMC health services research"},{"issue":"2","key":"pgph.0000009.ref015","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.arcped.2010.11.012","article-title":"Consultations it\u00e9ratives aux urgences p\u00e9diatriques [Repeat visits in a pediatric emergency department].","volume":"18","author":"L Maugein","year":"2011","journal-title":"Arch Pediatr"},{"issue":"12","key":"pgph.0000009.ref016","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1097\/00005650-199912000-00010","article-title":"The impact of competing subsistence needs and barriers on access to medical care for persons with human immunodeficiency virus receiving care in the United States","volume":"37","author":"W. Cunningham","year":"1999","journal-title":"Med Care"},{"issue":"5","key":"pgph.0000009.ref017","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.jemermed.2015.03.010","article-title":"Postgraduate Emergency Medicine Training in India: An Educational Partnership with the Private Sector","volume":"49","author":"K Douglass","journal-title":"Journal of Emergency Medicine"},{"issue":"2","key":"pgph.0000009.ref018","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2013 A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"P Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pgph.0000009.ref019","article-title":"REDCap Consortium, The REDCap consortium: Building an international community of software partners","author":"P Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"pgph.0000009.ref020","volume-title":"National Hospital Ambulatory Medical Care Survey: 2017 emergency department summary tables","author":"P Rui"},{"key":"pgph.0000009.ref021","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.annemergmed.2010.01.032","article-title":"Frequent users of emergency departments: the myths, the data, and the policy implications","volume":"56","author":"E LaCalle","year":"2010","journal-title":"Ann Emerg Med"},{"key":"pgph.0000009.ref022","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1111\/j.1553-2712.2011.01246.x","article-title":"Social and medical vulnerability factors of emergency department frequent users in a universal health insurance system","volume":"19","author":"G Bieler","year":"2012","journal-title":"Acad Emerg Med"},{"issue":"6","key":"pgph.0000009.ref023","doi-asserted-by":"crossref","first-page":"e0127793","DOI":"10.1371\/journal.pone.0127793","article-title":"Pre-emergency-department care-seeking patterns are associated with the severity of presenting condition for emergency department visit and subsequent adverse events: a timeframe episode analysis","volume":"10","author":"C Chan","year":"2015","journal-title":"PloS one"},{"issue":"2","key":"pgph.0000009.ref024","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4103\/2224-3151.206250","article-title":"Composition and distribution of the health workforce in India: estimates based on data from the National Sample Survey","volume":"5","author":"K Rao","year":"2016","journal-title":"WHO South-East Asia Journal of Public Health"},{"key":"pgph.0000009.ref025","volume-title":"Home","author":"R Tikkanen","year":"2020"},{"issue":"3","key":"pgph.0000009.ref026","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1017\/S1049023X14000296","article-title":"Emergency medical services in India: the present and future.","volume":"29","author":"M Sharma","year":"2014","journal-title":"Prehosp Disaster Med."},{"key":"pgph.0000009.ref027","first-page":"57","article-title":"Patients\u2019 experiences and expectations from an emergency department: a survey of 4,392 patients","volume":"7","author":"A. Issa","year":"2007","journal-title":"Middle East J. Emerg. Med"},{"key":"pgph.0000009.ref028","first-page":"3","article-title":"Patient expectations from an emergency medical service.","volume":"17","author":"W Qidwai","year":"2005","journal-title":"J. Ayub Med. Coll. Abbottabad"},{"key":"pgph.0000009.ref029","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1017\/S1481803500013658","article-title":"Patient expectations of emergency department care: phase II\u2013a cross-sectional survey","volume":"8","author":"T Cooke","year":"2006","journal-title":"Can. J. Emerg. Med"},{"key":"pgph.0000009.ref030","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1053\/ajem.2002.35452","article-title":"Parental expectations of care and charges in a tertiary care pediatric ED","volume":"20","author":"N Harris","year":"2002","journal-title":"Am. J. Emerg. Med"},{"issue":"6","key":"pgph.0000009.ref031","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0196-0644(96)70090-2","article-title":"Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department","volume":"28","author":"D Thompson","year":"1996","journal-title":"Ann Emerg Med"},{"issue":"5","key":"pgph.0000009.ref032","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/j.1553-2712.2012.01353.x","article-title":"Effect of Testing and Treatment on Emergency Department Length of Stay Using a National Database","volume":"19","author":"K. Kocher","year":"2012","journal-title":"Acad Emerg Med"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0000009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T13:23:04Z","timestamp":1644585784000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0000009"}},"subtitle":[],"editor":[{"given":"Paolo Angelo","family":"Cortesi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,11]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0000009","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,11]]}}}