Inappropriate use of emergency services: a systematic review of prevalence and associated factors

Author:

Carret Maria Laura Vidal1,Fassa Ana Claudia Gastal2,Domingues Marlos Rodrigues3

Affiliation:

1. Universidade Federal de Pelotas, Brasil; Universidade Católica de Pelotas, Brasil

2. Universidade Federal de Pelotas, Brasil

3. Universidade Federal de Pelotas, Brasil; Universidade do Vale do Rio dos Sinos, Brasil

Abstract

This systematic review aimed to measure the prevalence of inappropriate emergency department (ED) use by adults and associated factors. The review included 31 articles published in the last 12 years. Prevalence of inappropriate ED use varied from 20 to 40% and was associated with age and income. Female patients, those without co-morbidities, without a regular physician, without a regular source of care, and those not referred to the ED by a physician also showed more inappropriate ED use, with the relative risk varying from 1.12 to 2.42. Difficulties in accessing primary health care (difficulties in setting appointments, longer waiting periods, and short business hours at the primary health care service) were also associated with inappropriate ED use. Thus, primary care requires fully qualified patient reception and efficient triage to promptly attend cases that cannot wait. It is also necessary to orient the population on situations in which they should go to the ED and on the disadvantages of consulting the ED when the case is not really urgent.

Publisher

FapUNIFESP (SciELO)

Subject

Public Health, Environmental and Occupational Health

Reference51 articles.

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4. Discontinuity of care: urgent care utilization within a health maintenance organization;Plauth AE;Am J Manag Care,1998

5. Primary care physician and patient factors that result in patients seeking emergency care in a hospital setting: the patient's perspective;Boushy D;J Emerg Med,1999

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