Factors that influence the non-urgent use of emergency departments

Abstract

The changing role of emergency departments (ED) as providers of non-urgent care has been labelled inappropriate and a burden to healthcare systems. This has resulted in the development of intervention strategies aimed at diverting these nonurgent patients away from the ED to primary care providers who are able to effectively manage these conditions at a lower cost. The failure of diversion strategies thus far, highlights a gap in the understanding of the factors that influence these patients to seek non-urgent care in the ED. This study was designed with the aim to understand the patients perspective in the decision to seek non-urgent care in the ED as well as to establish whether this phenomenon is in any way related to what time of day or week these visits occur. The study was purely quantitative in nature and employed a self-administered questionnaire that was completed by 113 respondents in an ED of a private hospital in Johannesburg, South Africa. The results showed that non-urgent ED use is mainly a result of an interplay between the inadequate access to primary care and the convenience of the ED. The patient s perception of urgency was also found to influence this behaviour, as was the effect of medical insurance in shielding patients from realising the full cost of care in the ED. The study also distinctly pointed out differences in the factors that influence nonurgent ED use at different times of the day as well as on different days of the week.