Although emergency departments (EDs) serve the primary purpose of providing urgent care for a wide range of health problems, they are often misused for primary care of non-urgent health conditions; A practice that compromises their efficiency in treating emergency patients. Thus, the purpose of this study was conducted to explore the independent predictors of non-urgent ED visits in southwestern Ontario, Canada.
Methods:
Secondary analysis was conducted on archived administrative data of 597,373 patient visits to five EDs in southwestern Ontario, Canada over a one-year period. Specifically, stepwise binary logistic regression was conducted to identify the independent predictors of non-urgent ED visits in five community-based hospitals located in southwestern Ontario, Canada. We measured level of acuity using the Canadian Triage Acuity Scale which is mandated for use in all Canadian EDs.
Results:
Our results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit the ED for non-urgent causes. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts, respectively, compared to the day shift. Non-urgent ED visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts, respectively, compared to the day shift. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than patient self-referral. Patient diagnosis, type of hospital, mean of transportation, proximity to ED, and time of year were also independent predictors of non-urgent ED visits
Conclusion:
Our findings suggest that the issue of non-urgent ED visits is attributed to multiple modifiable patient and healthcare system factors. Thus, effective strategies to control and manage this issue shall be based on good understanding of such factors. Our finding that health care providers are more likely to refer patients to the ED for non-urgent complaints was surprising and is especially concerning.