Factors associated with non-urgent visits to the emergency department in a tertiary care centre, western Saudi Arabia: cross-sectional study

Al-Otmy, Saja S; Abduljabbar, Abeer Z; Al-Raddadi, Rajaa; Farahat, Fayssal

doi:10.1136/bmjopen-2019-035951

Cited by 26 publications

(47 citation statements)

References 22 publications

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“…15,30,[34][35][36][37] The acuity level in this study mostly features less urgent cases, which accords with other studies. 25 The chronic diseases, reported in this study, are lower than that of Al-Otmy etal. 25 One of the possible explanations might be due to that all public hospitals in Saudi Arabia have to accept all patients visiting the ED, which encourage patients to bypass the primary care centers, ignoring nature of ED services that must be for life saving conditions.…”

contrasting

confidence: 57%

“…25 The chronic diseases, reported in this study, are lower than that of Al-Otmy etal. 25 One of the possible explanations might be due to that all public hospitals in Saudi Arabia have to accept all patients visiting the ED, which encourage patients to bypass the primary care centers, ignoring nature of ED services that must be for life saving conditions. Previous literature has discussed different reasons for seeking ED visits.…”

contrasting

confidence: 57%

“…Emergency department overcrowding is becoming a challenge for the healthcare management system globally 22 and locally. 1 In Saudi Arabia, studies about ED visits mainly focus on a specific study population, ie drug-related problems, 23 triage system issues, 24 non-urgent visits, 25 duration of revisit, 26 or a specific group of patients, ie post bariatric surgery 27 and sickle-cell disease. 28 To our knowledge, the current study is among the few targeting all the adult patients frequenting the emergency department in tertiary care in Saudi Arabia.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Frequent Visits to the Emergency Department at a Tertiary Care Hospital in Saudi Arabia: Rate, Visitors’ Characteristics, and Associated Factors

Al-Surimi¹,

Yenugadhati²,

Shaheen³

et al. 2021

IJGM

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Background: Emergency department overcrowding is becoming a challenge for the healthcare management system globally and locally. This study aimed to estimate the frequency of ED visits, describe the patients' profile along with visit-related characteristics, and associated factors in a tertiary care hospital. Methods: A retrospective cohort study was conducted at a tertiary care hospital. The study included patients age 14 years and above visiting the main emergency department in year 2013. Data were extracted from electronic medical records by a qualified data extraction team. Statistical analyses were performed, including the odds ratio and 95% confidence interval for the factors associated with highly frequent (≥14 visits) ED visits using logistic regression models. Results: There were 150,727 visits to the emergency department within a year. The number of frequent visitors was 7696 (9.38%), with 42,226 visits (28.01% of total ED visits). Highly frequent visitors totaled 249 (0.30%), with 5173 visits (3.43% of total ED visits). The frequent visitors' average age was 42.55 (SD 20.14), and 48.99 (SD 21.33) for the highly frequent visitors' group. More than half of the emergency visitors were females. The most common complaints among the highly frequent visitors were Gastrointestinal (21.34%), followed by Respiratory (13.47%), Orthopedic (12.57%), and Cardiovascular (12.43%). Multivariate analysis indicated that age, history of diabetes, history of cardiac diseases, insurance status, and nationality were significant predicators of highly frequent visits to the hospital emergency. Conclusion: Frequent and highly frequent visitors to emergency departments represent a significant proportion of adult patients presenting to ED. Their visits constitute almost onethird of total ED visits. Several factors associated with highly frequent ED visits have been identified. This study provides local empirical evidence to develop improvement policy and actions related to chronic issue of frequent and highly frequent visitation to hospital ED.

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confidence: 57%

contrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Frequent Visits to the Emergency Department at a Tertiary Care Hospital in Saudi Arabia: Rate, Visitors’ Characteristics, and Associated Factors

Al-Surimi¹,

Yenugadhati²,

Shaheen³

et al. 2021

IJGM

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“…Similar findings were observed both nationally and internationally. 19 , 20 For example, in Riyadh—Saudi Arabia—79.9% of patients were dissatisfied with waiting time and 44% of patients felt neutral about the availability of requested lab results. 21 , 22 Such issues may be exacerbated by the high demands of such services due to the increasing rates of chronic diseases in recent years.…”

Section: Discussionmentioning

confidence: 99%

Perceived Barriers to Primary Care Services Utilization and its Associations with Overall Satisfaction of Patients in Saudi Arabia: A Cross-Sectional Questionnaire-Based Study

AlOmar

AlShamlan

AlAmer

et al. 2021

J Prim Care Community Health

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Introduction: Primary care plays an integral role in modern healthcare systems. More so in a country that is currently undergoing a reform of its health system. Their remains barriers that hinder patients from seeking medical assistance from primary physicians. This study aims to examine the overall satisfaction of patients toward Primary Healthcare Centers (PHCs) in Saudi Arabia, as well as its association with potential barriers from a sample of patients who presented at the emergency department (ED) for non-urgent cases. Methods: This cross-sectional study sampled 403 patients from King Fahd Hospital of the University. A piloted questionnaire was utilized that included questions on sociodemographics, satisfaction of PHCs, as well as organizational, socioeconomic, access, and patient-doctor relationship barriers using a Likert-scale item response. Chi-squared and Fisher’s Exact tests were used to compare categorical variables, and multivariable logistic regression was used to assess the association between overall satisfaction and all factors and barriers. Results: The sample consisted of 48.1% males and 51.9% females. Only 5.2% of the patients were hospitalized. Of the total sample, 28.3% reported being always satisfied with PHC services. The most reported barriers were organizational barriers and socioeconomic barriers. The regression analysis found that being a female, highly educated, have high organizational, and patient-doctor relationship were independent predictors for low overall satisfaction with PHCs. Conclusion: Findings from this study should allow healthcare planners and policy makers to reduce the impact of these barriers by finding solutions that would target them. This may include strictly implementing policies such as proper implementing of triaging in EDs as well as promoting services that are being provided free of charge at these centers.

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“…According to recent research of one tertiary hospital in SA, 78.5% of visits to the ER were of non-urgent cases [ 5 ]. Another research which looked into three tertiary hospitals in SA found that non-urgent cases comprised 53% of all ER visits and examining paediatric ER visits specifically, non-urgent cases ranged between 35.9 and 59.5% [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia

et al. 2021

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Background The Emergency Repartment (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia. Methods This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome. Results The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57–5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85–89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65–51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70–133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23–0.38). Conclusions A low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.

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Factors associated with non-urgent visits to the emergency department in a tertiary care centre, western Saudi Arabia: cross-sectional study

Cited by 26 publications

References 22 publications

Epidemiology of Frequent Visits to the Emergency Department at a Tertiary Care Hospital in Saudi Arabia: Rate, Visitors’ Characteristics, and Associated Factors

Epidemiology of Frequent Visits to the Emergency Department at a Tertiary Care Hospital in Saudi Arabia: Rate, Visitors’ Characteristics, and Associated Factors

Perceived Barriers to Primary Care Services Utilization and its Associations with Overall Satisfaction of Patients in Saudi Arabia: A Cross-Sectional Questionnaire-Based Study

Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia

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