Reasons for Avoiding their Local Clinics among Non-emergency Patients at Accident and Emergency Department, Pretoria, South Africa

Abstract

Background: An accident and emergency department (AED) is designated for patients who need to be seen urgently. However, at Jubilee Hospital, a large number of patients regularly presented directly to the AED with minor ailments. This resulted in long queues in the already overcrowded waiting room. Methods: A cross-sectional study design with a sample of 289 participants. Results: Those aged 21-40 years accounted for 44.6% of the participants. Patients mainly arrived on Fridays (72%), and medical-related complaints (128; 44.3%) were the most prevalent. In addition, patients primarily relied on public transportation to get there (180; 62.1%). In most cases, patients had previously visited clinics more than twice (141; 58.8%). Majority of patients were aware of the community health centres’ services. Only 33.6% of the clinics that were bypassed provided services 24 hours a day. Almost 80% of bypassed clinics were within 10 km of the District Hospital. Patients’ main reasons were long queues (89.6%) and medication shortages (67.6%). In 51.2% of cases, patients were aware of the referral system, but 14.5% did not think it made sense, and 11% did not understand it well. Conclusion: Proper strict application of the triage system and education of patients will decrease emergency department overcrowding. This will improve patient safety, clinical outcomes and the efficiency of the health system. In addition, changing local clinics’ operating hours will assist in reducing the high number of patients seen at Jubilee Hospital.