Ambulatory (P3) patients at the emergency department

Abstract

Introduction Overcrowding at Emergency Departments (EDs) has negative implications on healthcare systems, hospitals, staffs, and patients. We aimed to describe the characteristics of ambulatory (P3) patients to mitigate input of these patients to the ED to ease overcrowding. Methods A retrospective study was conducted from 2019 to 2022. Information on demographics, attendance patterns, length of ED stay, diagnoses and dispositions were collected and analysed. Results Among 541,762 attendances, there were 183,592 (33.9%) ambulatory (P3) patients. Adults between 16- to 65-year old accounted for the majority ( n = 149,846, 81.6%). Compared to emergent (P1) and urgent (P2) patients, there were greater proportions of ambulatory (P3) patients who attended the ED during weekends and public holidays, and between 0800 and 2359 h ( p < .01). There were also greater proportions of ambulatory (P3) patients who self-conveyed to the ED, and did not have referral from primary care physicians ( p < .01). Their median (interquartile range) time, in minutes, of wait for triage, wait for consult and length of stay were 9 (4–19), 35 (18–71) and 110 (65–168) respectively. About one in 10 ambulatory (P3) patients required admission to the hospital. The top three diagnoses were upper respiratory tract infection (11.0%), musculoskeletal pain (9.7%), and laceration (4.3%). Conclusion Ambulatory (P3) patients accounted for a sizeable load which can exacerbate overcrowding at the ED. They may be better sited at primary care services that are appropriate for their conditions. Measures should be directed at addressing their healthcare needs and health seeking behaviour.