Emergency Departments in Contemporary Healthcare: Are They Still for Emergencies? An Analysis of over 1 Million Attendances

Abstract

Background: Over the past few decades, emergency departments (EDs) have experienced an increasing workload. However, the variation in the types of patient accesses to these departments remains poorly understood. Objective: To evaluate the 5-year temporal trend in the volume of patients attending EDs based on the urgency of their conditions. Methods: This multicenter observational retrospective study was conducted from 1 January 2019, to 31 December 2023, across seven Italian EDs located within the same province. All patients accessing the EDs during the study period were included, totaling 1,282,735 patients. The triage code was used as an urgency index; non-urgent patients were defined as those who received a code 4 or 5 in triage, while urgent patients were defined as those who received a code 3, 2, or 1 in triage. Temporal analyses of admissions were conducted, also evaluating individual age groups to understand behavior over time. Results: From 2019 to 2023, there was a significant 10% increase in ED attendances by non-urgent patients. This increase was observed during both daytime and nighttime shifts. Notably, all age groups showed an increase in non-urgent patients, except for pediatric patients aged 0 to 14. Conclusions: Over the past 5 years, there has been a consistent upward trend in ED attendances by non-urgent patients. Healthcare policies should consider implementing strategies to manage or mitigate the overload in EDs, particularly related to non-urgent patient accesses.