Patients who return to the emergency department within a few days of discharge do so principally because they are anxious about their symptoms and have lost trust in other parts of the healthcare system, according to the results of a study published online today in Annals of Emergency Medicine.

“When asked why they did not follow up as an outpatient, patients reported feeling that their symptoms were too severe to wait until their scheduled appointment or being instructed to return to the ER by the outpatient provider they contacted,” said lead study author Kristin Rising, MD, of the Department of Emergency Medicine at Thomas Jefferson University in Philadelphia, Penn.

The paper goes on to say that patients’ “decision to return to the emergency department [was] driven largely by fear and uncertainty regarding their medical conditions as well as a lack of trust in the system to be responsive to their needs.” Other prominent themes related to patients’ limited use of outpatient care included problems accessing care because of lack of insurance, dissatisfaction with a primary care physician and lack of trust in their primary physician.