Non-urgent consultations in polyvalent emergency department: proportion and contributing factors

Abstract

INTRODUCTION: Overcrowding in emergency departments (EDs) is a concerning global problem with negative repercussions for patients and caregivers. It is partly due to non-urgent consultations. The aims of our study wereto determine the proportion of non-urgent ED visits and to identify factorsassociated. METHODS: Cross-sectional study with an analytical aim including patients aged over 15 years consulted a polyvalent ED during14-day period. Consultations were coded from 1 to 5 according to the Clinical Classification of Emergency Patients (CCMU). We compared 2 groups: group 1 with urgent consultation (CCMU 3,4 and 5) and group 2 with non-urgent consultation (classified CCMU 1 and 2). RESULTS: N= 589, mean age=42years with a female predominance (54.5%). Group 1 included 149 patients and the second Group 440 patients (74.7%). Patients were significantly younger in group 2 and 60.8% had social security coverage (p=0.006). Reasons that motivated the EDvisitwereproximity, search for a quick solution and ignorance of the appropriate health facility to attend (p<0.05). Independent factors of non-urgent ED visit were single status, self-referral to the ED, perception of the symptom as not severe, no attending physician, no history of similar symptoms, search for a quick solution, and patient-perceived need for further investigations. CONCLUSION: Easy access to investigations in EDs leads patients to consult them for non-urgent reasons. Better communication between them and basic health centers is recommended for the management of patients in CCMU 1 and 2 to avoid ED overload.