Al-Otmy Saja S, Abduljabbar Abeer Z, Al-Raddadi Rajaa M, Farahat Fayssal
Family medicine resident, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia.
BMJ Open. 2020 Oct 6;10(10):e035951. doi: 10.1136/bmjopen-2019-035951.
To explore magnitude and factors associated with non-urgent visits to the emergency department (ED) in a tertiary care centre, western Saudi Arabia.
A cross-sectional study.
ED of a tertiary care hospital in western Saudi Arabia.
400 patients, both men and women.
An interview-based questionnaire was administered to a consecutive sample of patients who visited the ED during morning shifts, where primary healthcare centres (PHCs) and outpatient clinics were available.
ED visits classified as non-urgent versus urgent (excluding life-threatening conditions) based on the Canadian Triage and Acuity Scale (CTAS). Levels IV and V were classified as non-urgent.
Majority of the cases were adult (97.3%) and half of them were women (54.8%). Non-urgent visits represented 78.5% among non-life-threatening cases. One-third of the patients (33.8%) had three visits or more to the ED during the past year. Main reasons for visiting the ED were perception that the condition was urgent (42.0%), easy access (25.5%) and limited resources and services at the PHCs (17.8%). Patients 40-50 years old were more likely to have non-urgent visits (OR=3.21, 95% CI 1.15 to 8.98). However, likelihood of non-urgent visits was significantly lower among patients with cancer (OR=0.37, 95% CI 0.19 to 0.72) and cardiovascular disease (OR=0.43, 95% CI 0.23 to 0.83), and those who live near the hospital (OR=0.49, 95% CI 0.28 to 0.88).
The current study reported overuse of the ED. Enhancement of the primary care services, in concordance with community awareness, is an important component to reduce burden due to non-urgent use of the ED.
探讨沙特阿拉伯西部一家三级医疗中心非紧急情况下急诊就诊的规模及相关因素。
横断面研究。
沙特阿拉伯西部一家三级医疗医院的急诊科。
400名患者，男女皆有。
对早班期间前往急诊科就诊的连续样本患者进行基于访谈的问卷调查，这些患者所在地区设有初级医疗中心（PHC）和门诊诊所。
根据加拿大分诊和 acuity 量表（CTAS），将急诊就诊分为非紧急与紧急（不包括危及生命的情况）。IV级和V级被归类为非紧急。
大多数病例为成年人（97.3%），其中一半为女性（54.8%）。在非危及生命的病例中，非紧急就诊占78.5%。三分之一的患者（33.8%）在过去一年中曾三次或更多次前往急诊科就诊。前往急诊科就诊的主要原因是认为病情紧急（42.0%）、就诊方便（25.5%）以及初级医疗中心资源和服务有限（17.8%）。40至50岁的患者更有可能进行非紧急就诊（OR = 3.21，95%CI 1.15至8.98）。然而，癌症患者（OR = 0.37，95%CI 0.19至0.72）、心血管疾病患者（OR = 0.43，95%CI 0.23至0.83）以及居住在医院附近的患者（OR = 0.49，95%CI 0.28至0.88）进行非紧急就诊的可能性显著较低。
本研究报告了急诊的过度使用情况。与社区意识相一致，加强初级保健服务是减轻因非紧急使用急诊而造成负担的重要组成部分。
