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"It needs to be recognised that every inappropriate attendance at the A&E would detract health professionals from attending to the genuine and often life-threatening emergencies," she added.
But it's hard to know what constitutes as inappropriate attendance.
(Health Care Professional) Participants described the difficulty in labelling a patient visit as an appropriate or inappropriate attendance.
Frequent attendance at general practice has also been found to be associated with an increased use of other health services such as out of hours services and "inappropriate attendance" at accident and emergency wards [ 6- 8].
Inappropriate attendance in antenatal care services (21.1%), late or wrong diagnosis (12.6%), inadequate management immediately after delivery (9.6%), no monitoring of blood pressure and other vital signs (9.2%) were the most prevalent factors contributing to the severe morbidity under study.
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Public education campaigns each resulted in a fall in inappropriate attendances of 27%to67%7%.
Unless staff of EDs have the time and resources to discuss preferences for referral out of their department in cases of inappropriate attendances, the community would need to look at punitive measures to discourage such inappropriate use.
More than three-quarters (79%) cited increased attendances at A&E as the reason for increased pressure, while 74% blamed inappropriate attendances at A&E where patients could have been treated by primary care services or by calling NHS 111. 5 live Investigates found the average A&E department had 9.7% of its posts vacant as of August 2013.
A study into inappropriate A&E attendance in the South Central region, for example, found that a quarter of patients were misdirected by staff who had limited knowledge of local alternatives to the A&E route.
This review indicates that single or short-term public education efforts tend to have a short-term impact in reducing apparent inappropriate ED attendances.
Indeed, such a wide range of inappropriate ED attendances underlines the difficulty in ascertaining their true rate.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com