Pather Michael, Mash Robert, Van Hoving Daniël J
Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
S Afr Fam Pract (2004). 2025 Apr 30;67(1):e1-e11. doi: 10.4102/safp.v67i1.6116.
Non-urgent patients are frequently found in emergency centres (ECs) and contribute to prolonged waiting times, overcrowding, high workloads and reduced quality of care. The aim of this study was to explore the perspectives of lead clinicians regarding patient attendance at ECs with non-urgent conditions in Western Cape district, South Africa.
An exploratory descriptive qualitative study in which semi-structured interviews with 19 family physicians and one emergency medicine specialist from 11 district hospitals and four community health centres were conducted.
Key reasons for non-urgent patients to attend the EC were a lack of access to primary care, poor understanding of emergencies and health services, issues related to work and transport, referral by general practitioners, being seen quicker, preference for a doctor, dissatisfaction with primary care and worries about confidentiality. The effects were seen as reduced quality of care for urgent and non-urgent patients, overcrowding, reduced staff morale, many complaints as well as abusive behaviour, manipulation of the triage system, longer triage and waiting times.
Action should be taken to: strengthen the primary care platform through better access, coverage and quality of care; educate communities and general practitioners; harness digital technology and telehealth; change the way emergency medical services operate and ensure adequate staffing of ECs. Alternative methods for offering primary care should be evaluated.Contribution: This article discusses the reasons for, effects of, and possible solutions to the problem of non-urgent patients attending ECs. Further studies may explore the perspectives of patients and medical officers.
急诊中心经常会遇到非紧急情况的患者，这导致了等待时间延长、过度拥挤、工作量大以及医疗质量下降。本研究的目的是探讨南非西开普地区主要临床医生对非紧急情况患者前往急诊中心就诊的看法。
进行了一项探索性描述性定性研究，对来自11家地区医院和4家社区卫生中心的19名家庭医生和1名急诊医学专家进行了半结构化访谈。
非紧急情况患者前往急诊中心就诊的主要原因包括：无法获得初级医疗服务、对紧急情况和医疗服务理解不足、与工作和交通相关的问题、全科医生的转诊、希望更快得到诊治、对医生的偏好、对初级医疗服务不满意以及担心隐私问题。这些情况导致了紧急和非紧急患者的医疗质量下降、过度拥挤、工作人员士气低落、大量投诉以及辱骂行为、分诊系统被操纵、分诊和等待时间延长。
应采取以下行动：通过改善医疗服务的可及性、覆盖范围和质量来加强初级医疗服务平台；对社区和全科医生进行教育；利用数字技术和远程医疗；改变紧急医疗服务的运作方式，并确保急诊中心有足够的工作人员。应评估提供初级医疗服务的替代方法。贡献：本文讨论了非紧急情况患者前往急诊中心就诊问题的原因、影响和可能的解决方案。进一步的研究可以探讨患者和医务人员的观点。
