Barriers to Primary Care: Perceptions of Older Adults Utilizing the ED for Nonurgent Visits

Deborah A. D'Avolio, Neville E. Strumpf, James Feldman, Patricia Mitchell, Casey M. Rebholz

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


This purpose of this mixed methods study was to understand access to primary care among older adults who present to an inner city emergency department (ED) for nonurgent care. Questionnaires (N = 62) included demographic, illness characteristics, and health care utilization. Qualitative interviews (N = 20) were conducted. Data was analyzed using descriptive statistics, and qualitative methodology. More than half of the participants were female (60%), African American (57%) and pain was the presenting symptoms among 48% of the participants. Nearly all participants reported barriers to primary care; difficulty with phone systems and staff, and lack of available appointments resulting in an ED visit. Older adults face barriers accessing primary care and as a result, can turn to the ED for their primary care needs. Interventions to improve access for vulnerable older adults might have benefits not only for patient outcomes but also for health policy issues related to cost effective care and overcrowded EDs.

Original languageEnglish (US)
Pages (from-to)416-431
Number of pages16
JournalClinical Nursing Research
Issue number4
StatePublished - Nov 2013
Externally publishedYes


  • barriers
  • emergency department (ED)
  • older adults
  • primary care

ASJC Scopus subject areas

  • General Nursing


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