Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T12:47:11.607Z Has data issue: false hasContentIssue false
  • English
  • Français

The Hospital Accident and Emergency Department: What is its Role?

Published online by Cambridge University Press:  20 January 2009

Michael Calnan
Get access Rights & Permissions [Opens in a new window]

Abstract

The problem over the use of accident and emergency departments is portrayed in terms of a typical conflict between professional and lay needs. However, in contrast with the more common image of the professional hospital doctor successfully developing both structural and interactional strategies for maintaining professional dominance over the patient, it is argued that the structural characteristics of the accident and emergency department pose control problems for the profession. These control problems have been exacerbated by developments in other areas of the health service and have led to the development of policies which emphasize both clinical and social elements of patient need. Although there is apparent recognition by providers of the importance of taking into account patient need, the proposed policies are based on professional images of how patients ‘ought’ to use the service. What is clearly lacking is comprehensive data on how the public and the community wishes to use the service and how they actually use the service. Data from national and local studies on patient felt needs and patient demand for the hospital accident and emergency departments are presented and the implications for policy are discussed.

Type
Articles
Information
Journal of Social Policy , Volume 11 , Issue 4 , October 1982 , pp. 483 - 503
Copyright
Copyright © Cambridge University Press 1982

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Armstrong, D. (1974), ‘Hospitals’, in Carter, J. (ed.) Problems in the Maltreated Child, Piory Press, London, pp. 45–67.Google Scholar
Armstrong, D. (1979), ‘The emancipation of biographical medicine’, Social Science and Medicine, 13 A, 1–8.Google Scholar
British Orthopaedic Association (1973), Casualty Departments – The Accident Commitment, London.Google Scholar
Calnan, M., with the assistance of Abson, E. and Butler, J. R. (1979), Pathways to the Accident and Emergency Department, Health Services Research Unit Report, University of Kent at Canterbury.Google Scholar
Calnan, M. (1981), Coping with Accidents and Emergencies: A study of how the community uses the hospital accident and emergency department, Ph.D Thesis, University of Kent at Canterbury.Google Scholar
Cang, S. (1978), ‘Structural aspects of doctor-patient relations’, in Jacques, E. (ed.) Health Services, Heinemann, London, pp. 53–68.Google Scholar
Caro, D. B. (1972), ‘The Casualty Surgeons' Association’, Postgraduate Medical Journal, 48, 20–2.CrossRefGoogle ScholarPubMed
Cartwright, A. and Anderson, R. (1979), Patients and Their Doctors, Occasional Paper 8, Royal College of General Practitioners.Google ScholarPubMed
Casualty Surgeons' Association (1973), An Integrated Emergency Service, CSA, London.Google Scholar
Central Health Services Council (1962), Report of the Sub-Committee, HMSO, London.Google Scholar
Central Health Services Council (1969), Functions of the District General Hospital, Report of the Committee, HMSO, London.Google Scholar
Cullinan, T. R. (1978), A Study of Patients' Use of an Accident and Emergency Department, unpublished report, St Bartholomew's Hospital.Google Scholar
Dixon, P. N. (1969), ‘The work of a nurse in a health centre treatment room’, British Medical Journal, 4:10, 292–4.CrossRefGoogle Scholar
Eckstein, H. (1960), Pressure Group Politics, Allen and Unwin, London.Google Scholar
Fairley, J. and Hewett, W. C. (1969), ‘Survey of casualty departments in Greater London’, British Medical Journal, 2, 375–7.CrossRefGoogle ScholarPubMed
Freidson, E. (1975), The Profession of Medicine, Dodd and Mead, New York, 2nd edition.Google Scholar
Gibson, H. (1978), ‘The dressing clinic in an accident and emergency department’, in Davis, A. (ed.) Relationships between Doctors and Patients, Saxon House, Farnborough, Hants., pp. 13–21.Google Scholar
Gunawardena, A. and Lee, K. (1977), ‘Access and efficiency in medical care: a consideration of accident and emergency services’, in Barnard, K. and Lee, K. (eds) Conflicts in the NHS, Croom Helm, London, pp. 56–68.Google Scholar
Holohan, A. (1976), ‘Illness and accident behaviour’, in Stacey, M. (ed.) The Sociology of the NHS, Sociological Review Monograph, 22, pp. 111–19.Google Scholar
House of Commons Expenditure Committee (1974), Fourth Report – Accident and Emergency Services, Vol. 1, HMSO, London.Google Scholar
Johnson, T. (1972), Professions and Power, Macmillan, London.Google Scholar
Karondiker, D. (1980). ‘The casualty patients who bypass G. P. referral’, The General Practitioner, 19, 53–7.Google Scholar
Maclntyre, S. (1978), ‘Obstetric routines in antenatal care’, in Davis, A. (ed.) Relationships between Doctors and Patients, Saxon House, Farnborough, Hants., pp. 76–105.Google Scholar
Morgan, W., Walker, J. H., Holohan, A. M. and Russell, I. T. (1974), ‘Casual attenders: a socio-medical study of patients attending A and E departments in Newcastle’, Hospital and Health Services Review, vol. 70, 189–94.Google Scholar
McKinlay, L. J. (1973), ‘Social networks, lay consultation and help seeking behaviour’, Social Forces, 51, 275–81.CrossRefGoogle Scholar
National Provincial Hospitals Trust (1960), Casualty Services and Their Setting, Oxford University Press, London.Google Scholar
Navarro, V. (1977), Social Security and Medicine in the USSR, a Marxist Critique, Lexington Books, D. C. Heath, Lexington, Massachusetts.Google Scholar
Patients Association (1972), The Personal Doctor – a Vanishing Species?, Press release, 10 01.Google Scholar
Robertson, L., Kosa, J., Heagarty, M. C., Haggerty, R. and Alpert, J. J. (1974), Changing the Medical Care System, Praeger, New York.Google Scholar
Roth, J. A. (1971), ‘Utilisation of the hospital emergency department’, Journal of Health and Social Behaviour, 12, 312–20.CrossRefGoogle ScholarPubMed
Roth, J. A. (1975), ‘The treatment of the sick’, in Kosa, J. and Zola, I. K. (ed.) Poverty and Health: a sociological analysis, Harvard University Press, Cambridge, Massachusetts.Google Scholar
Royal College of General Practitioners (1976), Report on the Second National Morbidity Survey, RCGP.Google Scholar
Russell, I. T. and Holohan, A. M. (1974), Newcastle Accident Survey, Report on Phases i and iii, The choice of care for minor trauma, Medical Care Research Unit, University of Newcastle.Google Scholar
Strong, P. M. (1979), The Ceremonial Order of the Clinic, Routledge and Kegan Paul, London.Google Scholar
Shortell, M. (1974), ‘Occupational prestige differences within the medical and allied health professions’, Social Science and Medicine, 8, 1–9.CrossRefGoogle ScholarPubMed
Stimson, G. V. (1976), ‘General practitioners and types of trouble’, in Stacey, M. (ed.) Sociology of the NHS, Sociological Review Monographs, 22, 11. 43–60.Google Scholar
Wilkinson, A., Cazantzis, G., Williams, D., Dewar, R., Bristow, K. and Miller, D. L. (1977), ‘Attendance at a London casualty department’, Journal of Royal College of General Practitioners, 185, 27–33.Google Scholar