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

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.

The Value of the Medical Home for Children Without Special Health Care Needs

“…42,43 A reduction in ED utilization for sick visits of close to 30% would therefore represent a significant cost savings. Furthermore, our data demonstrated that preadolescents, who are more likely to have inappropriate ED utilization than adolescents or adults, 44 may benefit the ARTICLE most from having a medical home. Thus, although further studies are needed, promoting the medical home among children without special health care needs presents a promising avenue for additional cost savings and improved health.…”

Impact of a mass media mental health campaign on psychiatric emergency department visits

“…The prevalence of inappropriate ED use, if appropriate use is defined as presenting with a medical condition that could only be assessed in the ED, varies from 20% to 40%. 24,25 Reasons for choosing to visit the ED are lack of awareness of other facilities, perceived seriousness of the condition, trust in the ED staff and proximity to the ED. 25 Patients with inappropriate PED visits due to the lack of Table 3.…”

Influence of scheduling in clinical dental care on indicators of oral health

“…This emphasizes the importance of using tools for family, individual and social risk classification to improve dental care in these sectors and prevent emergency situations 18 . Therefore access to primary care eases the burden of dental emergency provided the care of emergency in time and in an opportune manner is guaranteed 19 .…”