Inappropriate emergency department attendances: patients’ characteristics

Abstract

Introduction: In recent years there has been an increasing demand for emergency department services. Nevertheless, a large proportion of the patients who use the emergency departments are characterized as “inappropriate” as the presenting health problem is not real emergency and could be treated at the level of primary care. Method: A systematic review of studies in the databases 'PubMed' and 'Scopus' was performed on the use of emergency departments by patients with inappropriate visits, with the aim to identify patient characteristics associated with such visits. Thirteen articles were finally included. Results: Inappropriate visits were found to range from 9.6% to 55%. Inappropriate visits were associated with age (in the 18 to 40 age group), time of visit (afternoon hours), economic status (patients with lower income), duration of symptoms (patients with symptoms lasting more than 24 hours) and with frequent users (patients who make frequent visits to EDs). No definite conclusions could be drawn for gender, occupational status, insurance coverage and day of attendance as the results from the studies were equivocal. Finally, marital status, educational level and the patient's distance from the hospital were not associated with inappropriate visits to the EDs. Conclusions: In summary, all studies in the current systematic review highlighted that rates of inappropriate attendance are high. Future studies addressing the prevalence of inappropriate attendances and the reasons patients use Emergency Departments should be conducted.