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J R Soc Med. 1983 January; 76(1): 37–40.
PMCID: PMC1438564

Use and misuse of an accident and emergency department in the East End of London.


A study was made of all 587 new patients attending an accident and emergency department in the East End of London during one week. Two hundred and twenty-six (39%) cases were not accidents or emergencies; of these, 67% were self-referrals who had not previously seen their general practitioner (GP) and 21% were self-referrals who had previously seen their GP. The four main reasons that these self-referred patients had for attending were that they thought their condition needed immediate attention; they were insufficiently organized to see their GP; they were not registered with a GP; or they wanted a second opinion. Twenty-eight (12%) of the cases which were not accidents or emergencies were referred by a GP. Sixty-nine (12%) of all cases were not registered with a GP. The frequency of cases who were not accidents or emergencies was significantly higher in those not registered than in those registered (0.01 greater than P greater than 0.001). Nineteen (3%) patients were living rough or in hostels. Little abuse of the ambulance service was found.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • FRY L. Casualties and casuals. Lancet. 1960 Jan 16;1(7116):163–166. [PubMed]
  • MESTITZ P. A series of 1,817 patients seen in a casualty department. Br Med J. 1957 Nov 9;2(5053):1108–1109. [PMC free article] [PubMed]
  • Ogg TW. Use of anaesthesia. Implications of day-case surgery and anaesthesia. Br Med J. 1980 Jul 19;281(6234):212–214. [PMC free article] [PubMed]
  • Rutherford WH. A study of new patients attending the accident and emergency department of the Royal Victoria Hospital, Belfast, from 25th January, 1970, to 31st January, 1970. Ulster Med J. 1971 Winter;41(1):10–16. [PMC free article] [PubMed]

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