Why non-urgent patients go to the Emergency Department? - study at a portuguese Primary Healthcare Center

Vitória Aleixo, Maria Couto

Keywords: Primary Care; Primary Healthcare Center; Emergency Department; non-urgent patients; Manchester triage scale; Accessibility

Background:
In Portugal, the Healthcare Service is organized so that Primary Care are the first line access to the healthcare system. Simultaneously, Hospital Emergency Departments are open to all population to assist patients with acute, moderate to severe health problems. The access of patients to the Emergency Departments (ED) instead of Primary Care in non-urgent situations leads to overcrowded ED and delays patient assistance. People classified as blue or green in the Manchester triage scale could be managed at the primary health care setting. It is necessary to understand the reasons leading this patients to the emergency departments. We intend to assess if patients belonging to our Primary Healthcare Center go to the ED of the nearest Hospital with non-urgent problems and, if so, explore their motives, so we can work on solutions that answer patient’s needs.

Research questions:
Why do our non-urgent patients choose the nearest ED instead of their Primary Healthare Center

Method:
Observational study, descriptive and cross-sectional. Initially retrospective, with collaboration of the nearest hospital, to assess how many patients from our Healthcare Center went to their ED during 2021, and a list of those who were assigned with a blue or green bracelet. Then, by phone call, ask this patients to answer a multiple-choice questionnaire about why they preferred the ED at that episode. The primary outcome is to assess the main reasons that led non-urgent patients belonging the our Primary Healthcare Center to resort to the Hospital instead of the Primary care; as secondary outcomes, we will evaluate the proportion of our patients that went to that ED in 2021; Proportion of this patients that have been admitted as blue or green; Proportion of patients admitted as blue or green that, according to the final diagnosis and discharge destination, could be treated at the Primary Care Health Center.

Results:

Conclusions:

Points for discussion: