Patient's Perspective for their Non-Urgent Presentations to the Emergency Department in Najran City

Abstract

Aim of Study: To explore patients’ perspectives regarding the reasons why some less urgent, or non-urgent patients prefer to attend emergency departments (EDs) instead of using other more appropriate healthcare services. Methods: This study followed a quantitative cross-sectional design. The study obtained and analyzed emergency attendance data from King Khalid Hospital, Najran City. A study questionnaire was designed by the researcher to interview 400 ED patients, who inappropriately attended the ED, to identify the reasons for their inappropriate attendance to the ED. Data collection was performed during the period of two months (November-December, 2022) to explore the proportions of different attendances that were deemed inappropriate according to the hospital’s followed triage system. The interviews were conducted with the non-urgent and less urgent patients during their waiting times. Results: The age of 18.3% of patients were <30 years old, while 28.5% were 30-39 years old. More than half of the participants’ visits were non-urgent, while 43.25% were less-urgent, 55.3% of patients visited the ED before due to similar complaints, and 46% visited a primary health care center before their ED visits. The main reasons for visiting the ED instead of the primary healthcare center (PHCC) were to save time (49.3%) and to get an earlier appointment (48%). Patients’ triage levels differed significantly according to their age groups (p<0.001), nationality (p=0.022), educational level (p=0.022), marital status (p=0.002), ED visits due to similar complaints (p<0.001), and previously visiting the PHCC for the current health problem (p=0.002). Triage levels also differed significantly according to some reasons for choosing to go to the ED instead of the PHCC, especially to get an earlier appointment (p=0.044), preferring the healthcare services provided by the ED (p=0.005), having a nearby ED (p=0.001), or being at the hospital at that time (p=0.002). Conclusions: There is a clear relationship between inappropriate ED visits and certain associated factors, indicating that prevention would be best targeted to certain categories, such as Saudi, younger, and educated patients. The main reasons for inappropriate ED visits are to save time and to avoid getting a late appointment. Recommendations: This study emphasized the importance of implementing proper health education and redirecting patients with inappropriate ED visits. Conducting a detailed analysis of the shortages in the utilization of primary healthcare resources is a pressing necessity. Further nationwide studies on patients’ perspective for non-urgent ED presentations are largely needed. Key Words: Emergency Department, Triage, Quantitative Research, Najran City, Saudi Arabia