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Emergency department use by CTAS Levels IV and V patients

Published online by Cambridge University Press:  21 May 2015

Simon Field  and
Andrea Lantz
Simon Field*
Affiliation:
Department of Emergency Medicine, Dalhousie University, Halifax, NS
Andrea Lantz
Affiliation:
Faculty of Medicine, Dalhousie University, Halifax, NS
*
Department of Emergency Medicine, Dalhousie University QE II Health Sciences Centre, 3021 – 1796 Summer St., Halifax NS B3H 3A7

Abstract

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Introduction:

Many emergency department (ED) visits are non-urgent. Postulated reasons for these visits include lack of access to family physicians, convenience and 24/7 access, perceived need for investigations or treatment not available elsewhere, and as a mechanism for expedited referral to other specialists. We conducted a patient survey to determine why non-urgent patients use our tertiary care ED. Our primary objective was to determine how often the lack of a family physician was associated with non-urgent ED use.

Methods:

The survey was administered to Canadian Emergency Department Triage and Acuity Scale (CTAS) Level IV and V patients who attended the ED of the Queen Elizabeth II Health Sciences Centre in Halifax, NS, from March 7 to March 13, 2005.

Results:

Of the 352 eligible patients, 235 completed the survey (response rate, 67%). Fifty-six percent (132/235) had an acute medical problem of less than 48 hours, including 48% (114/235) with a recent injury. Thirty-four percent (82/235) had been referred to the ED, 49% (114/235) believed they required a specific service that was unavailable elsewhere (e.g., radiology, suturing, casting) and 43% (100/235) presented because of self-perceived urgency of their condition. Eighty-four percent (198/235) had a family physician; 23% (55/235) used the ED because of limited access to theirfamily physician and 3% (6/235) used the ED because they did not have a family physician.

Conclusions:

In this setting, most non-urgent ED visits involved patients who required a specific service offered by the ED, patients who believed their condition was urgent, or patients who were referred from the community to the ED. From a patient perspective, relatively few visits would be considered inappropriate. Lack of a family physician was not associated with non-urgent ED use; however, inability to obtain timely access to the FP was a factor in one-quarter of cases.

Keywords

Canadian Emergency Department Triage and Acuity ScaleCTASnon-urgentacuity
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 5 , September 2006 , pp. 317 - 322
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

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