Why are men more likely to use A&E?

Health chiefs are puzzling over new research that reveals men are more likely than women to use Accident and Emergency services for relatively minor health problems.

Primary Care Trust researchers spent three days interviewing patients in the A&E department of the Norfolk and Norwich University Hospital trying to identify why ever-increasing numbers of people are attending A&E with comparatively minor illnesses or injuries.

And the research showed that around three-quarters of patients had attended A&E for minor health problems and of that total, 65 per cent were men. The overall figures for the Norwich A&E department also confirmed that more men than expected use the emergency service during the course of a year.

The hospital serves a population* of 574,000, of which 49 per cent are male and 51 per cent are female. But the figures for Norwich’s A&E, used by more than 66,000 patients a year, show the service is used by 56 per cent men and 44 per cent women.

Now NHS chiefs are looking at why it might be that men are more likely to use A&E services for relatively minor problems, and women are less likely to.

Dr Neil Cooper, a social psychologist from the University of East Anglia and a former nurse, believes there are very good social reasons that help explain the trend. He does not believe it is because women are tougher than men but rather that men and women behave differently in relation to health issues.

“People often say that when it comes to health, men are wimps compared to women, but that’s unfair. Research into men’s use of health services show that men tend not to access health care until they are ill or are especially worried about a health problem. Men’s habits in health are linked to how men see themselves. They make little use of preventative services and tend not to talk about health problems and often regard going to the doctor as a sign of weakness.

“Women, on the other hand, tend to be more involved with health care and are used to accessing routine service for reproductive and screening purposes. Men have health problems but may ignore symptoms or get advice informally from friends. This means when men have a minor injury or illness that needs examination they resort to a quick fix at casualty rather than using more locally based services.

“Making an appointment for the doctors for a minor health problem may be perceived by men as whinging. By attending casualty their problem is seemingly more serious and perhaps they are happier their concern was more justified and more manly. Health services have to engage men more in routine ways to enable them to get the most appropriate help.

The research did also highlight a need for the NHS to provide better information on what alternatives to A&E there are on offer such as Walk In Centres, Minor Injury Units, GPs, and pharmacists.

Accident and Emergency

A&E services are designed to help people with critical or life-threatening problem such as:

• Unconsciousness
• Heavy blood loss
• Suspected broken bones
• A deep wound such as a stab wound
• A suspected heart attack
• Difficulty in breathing
• Severe burns
• Severe allergic reaction

For less serious health problems the alternatives in central Norfolk are:

Self care

Coughs, colds, indigestion, cuts and bruises can be handled by a well-stocked medicine cabinet

Pharmacy

A pharmacist can give advice about treating many common illness and on over the counter and prescription medicines.

Norwich NHS Walk-in Centre

The Walk-In Centre, Pound Lane, Dussindale, is open 7 days a week, 7am to 10pm Monday to Saturday, and 9am to 10pm on Sundays and bank holidays. No appointments are needed and the nurses can help with minor ailments and injuries such as:

• Cuts
• Bruises
• Sprains
• Rashes
• Eye problems
• Minor infections
• Minor burns

Cromer & District Hospital Minor Injuries Unit

Cromer's MIU, Mill Road, is open from 8am to 10pm, seven days a week, and its nurses can treat a range of minor injuries.

 What Cromer's MIU can help with

• Minor head injuries (with no loss of consciousness)
• Simple wounds
• Simple eye conditions, foreign body, corneal abrasions
• Minor burns
• Soft tissue injury
• Bites and stings, with no associated complications, or acute reaction
• Simple fractures
• Fingers that may be broken or dislocated 

 What Cromer's MIU cannot deal with

• Children under the age of two
• Pregancy problems
• Complicated or serious injury
• Fractures that may need manipulation (other than fingers) 
• Head injury where there has been loss of consciousness
• Alcohol-related head injuries or illnesses 
• Medical conditions in their acute form, asthma, diabetes, allergic reaction       
• *Major illness i.e. Stroke, Heart attack

*These patients should attend the Accident and Emergency department at NNUH. In an emergency, call 999 for an ambulance.

Out of hours service

Anglian Medical Care provides an out-of-hours service for GPs’ patients from 6.30pm to 8am, 01603 488488.

Notes to editors:

Seventy people were interviewed in three sessions. (1) Mid morning to mid afternoon on Sunday 10th October 2004; (2) Mid morning to early afternoon on Monday 11th October 2004; (3) Early to late evening on Monday 11th October 2004.

*Source: Office for National Statistics; data for 2002 shows the population of Breckland, Broadland, Norwich, South Norfolk and North Norfolk combined is 574,000 and is spilt 51% female and 49% male.

Media contact: Communications on 01603 287200.

A&E Case Study 1 (based on a real case)

A 50-something man attends A&E having got a drawing pin in his hand. He had removed the drawing pin at home and there was no bleeding. As his hand hurt he went to A&E for help. He was asked why he’d decided he needed to come to A&E and responded that his hand hurt. He was given some paracetamol, antiseptic cream and a plaster were applied to his hand, and he was sent home.

A&E Case Study 2 (based on a real case)

A 20-something female student attended A&E. When asked by the nurse what was wrong she said she’d had a flu jab and felt a bit off colour. She added that when she’d had her injection she’d been told it might be best not to be on her own afterwards if she was worried. As she was on her own, she decided it would be best to come to A&E. She was sent home and told to rest and it was recommended that if she continued to feel unwell she should see her GP.