The causes of visits of non-urgent patients to an emergency department in King Fahad Hospital-Albaha-Kingdom of Saudi Arabia

Abstract

OBJECTIVE: The use of the emergency department by patients presenting with non-urgent conditions has become an important problem that is faced by all local and global health systems. The main objective of this article is to determine the causes of non-urgent emergency department visits by patients. METHOD This is a retrospective, descriptive study, conducted in the emergency department from January to April 2020. All patients triaged according to the Canadian Triage and Acuity Scale (CTAS) as CTAS -5 (non-urgent conditions) were included during the study period and their data such as demographics and presenting complaints were extracted from the hospital electronic files. Ethical approval was taken from the hospital's ethical review board. RESULTS Out of 1308 patients that visited the emergency department (ED), 327 (25%) patients were categorized as non-urgent visits (CTAS-5) according to the triage system. There was a slight female predominance of 165(50.5%) as compared to males 162(49.5%). 71% of patients were between 20-40 years of age. It was identified that 92% of the selected patients had non-urgent conditions, did not need any treatment in ED, and could be treated and followed up in primary health clinics or hospital polyclinics. 32.7% of patients had no chronic illness and 32.1 % of the patients had visited the ED before at least one time for the same complaint. The most common complaints at presentation for non-urgent visits were musculoskeletal system pain (30.5%), mild non-surgical abdominal pain (17.7%), Upper respiratory tract infection (9.5%), and fever (3.7%). It was found that 5.8% needs to be upgraded to CTAS 3-4 zone for further assessment and management. CONCLUSION The majority of non-urgent visits at the emergency department could be treated in other facilities like primary health care and hospital polyclinics. Proper, safe application of triage system and necessary education to the patients can reduce the emergency department overcrowdedness which will ensure patients safety and improve patients' clinical outcome.