Utilization of Emergency Department in Patients With Non-urgent Medical Problems: Patient Preference and Emergency Department Convenience
Received 26 November 2008; received in revised form 23 June 2009; accepted 8 October 2009.
Background/Purpose
We investigated the factors associated with emergency department (ED) use among patients with non-urgent medical problems, with a focus on convenience and preference to use the ED instead of primary care clinics.
Methods
A five-level triage system was adopted by research nurses to decide each patient's triage level and the maximum time to physician interview. Patients who had a maximum time to physician interview of more than 60 minutes were assumed to be non-urgent in this study.
Results
More than half of ED visits were considered to be non-urgent. Non-urgent patients were more likely to be unmarried, government employees, visit the ED due to trauma, have a history of chronic illness, and present in the day time or at the weekend. ED visits were also more likely to occur in patients who took less than 15 minutes to reach the ED, chose the ED for its convenience, agreed that they could have chosen another facility for their visit, did not agree that the ED was convenient for receiving medical care. Multivariate logistic regression showed that marital status, time of presentation, time needed to get to the ED, and occupation were associated with non-urgent ED visits.
Conclusion
Preference for using EDs for medical care and their convenience might contribute to non-urgent ED visits. A five-level triage system reliably stratified patients with different admission rates and utilization of medical resources, and could be helpful for reserving limited medical resources for more urgent patients.
cDepartment of Senior Citizen Service Management, National Taichung Nursing College, Taichung, Taiwan
dDivision of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
Correspondence to: Dr Yia-Wun Liang, Department of Senior Citizen Service Management, National Taichung Nursing College, 193, Section 1, Sanmin Road, Taichung, Taiwan
ABSTRACT