Non-Urgent Visits to Emergency Department: Consequences and Solutions

This article discusses the reasons for non-urgent visits to the emergency department, their consequences, and possible solutions. It also highlights the importance of primary care facilities and patient education.

Running head: HEALTH CARE
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Name of the University
Author Note

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Why is the hospital emergency department sometimes used for non-urgent conditions? What
are the consequences?
The services that are meant for the non-urgent emergency care services can be referred to as a
visit to the hospital settings for any clinical condition, whose delay would not cause any
lethal outcome. As per several studies, 30 % of the emergency department visits has been
found due to the occurrence of any non-urgent clinical conditions. Bed blocking is a term that
is frequently used by the clinicians, which can be referred to as an important public health
problem (Alyasin & Douglas, 2014). Normally, the clients in a hospital setting should be
prioritised or categorised on the basis of their emergency needs. The urgent cases are
generally admitted in to the emergency department and the non-urgent cases are sent for
evaluation in the primary care centre or some of the fast track departments (Idil et al., 2018).
Schumacher et al., (2013) have reported several parameters that causes the patients to rush to
the emergency departments. Patients do not find hour friendly primary care services, whereas
in the emergency departments, the patients can even get care in the odd hours and even in the
weekends which might not be got in a primary care setting (Schumacher et al., 2013). The
emergency department is equipped all the medical devices which cannot be seen in primary
care centres, this immediate reassurances can be provided to the patient about the treatment.
Patients are also referred to the ED from the primary care facilities, if case the health of the
patient deteriorates. There are certain legal and ethical obligations while admitting a patient
to the ED. Crowding in the ED can be an important indicator of the faults in the primary care
system (Schumacher et al., 2013). The number of health care consumers are rising day by day
added on by the growing aged population. Furthermore the the supply and the funding of the
primary care centers are out spaced by the burden of the chronic disease conditions. The gaps
left by the primary care facilities is being filled up by the ED. According to Alyasin and

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Douglas, (2014), the elderly patients face problems in the decision making process to
understand the seriousness of their health problem, or they actually needs to be admitted to
the ED or not. Sometimes, all the medial requirement of the patient at the emergency
department at a go. In such cases, it the emergency departments that provides all the
necessary care under one roof and hence the patient might not want to visit several places for
seeking different medical services. The ED visits differentiated at the triage as the non-urgent
are considered to represent ED visits that are not necessary. There is a common perception of
the patients who has been admitted in the ED department, that ED contains all the heath care
resources required for each acute complaints that require prompt attention. Again, the
insurance services has again increased the trend of the emergency visits. According to
Geelhoed & de Klerk, (2012), the non-urgent ED visits has been found to be in higher rate
among the Medicaid patients and those who receive self-pay visits. According to Raven et al.,
(2016), the implementation of the Affordable care act and the flexible insurance coverage are
leading to higher ED usage. Discrepancies have been found in the viewpoint of the ED
health practitioners and the ED patients (Durand et al., 2012). The viewpoints of the ED
patients were based on some of the medical factors like anxiety, pain, percentage by which
the clients are getting access to the health care.
Consequences
Non-urgent visits to the emergency department negatively affects the quality of
patient satisfaction and care. Visit to the ED for conditions that are not urgent can lead to
increased spending on the health care facilities. This is due to unnecessary testing and
treatment as every condition might not require the evaluation procedure or the time that are
actually conducted in an emergency department. An estimated amount of $4.6 billion could
have been saved, had the ED visits were controlled (Uscher-Pines et al., 2013). This could

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have been controlled by making the assessment in the urgent care centers and the primary
care centers. Usage of ED due to non –urgent cases can cause excessive crowding, increase
the workload of the emergency nurses, which gain can lead to medical errors or people who
are in actual need of the care fail to receive treatment. Furthermore, it also lowers the quality
of care for the patients (Durand et al., 2016). It can be estimated that if the non-urgent visits
in the ED department are not controlled and the primary care facilities are not increased, the
use of the Ed will increase in the near future. Disproportionate frustrations has been caused
among the staffs as they are of the perception that they are not doing the job as per their
qualification or for what they are actually trained for. As stated by O’Keeffe et al., (2018), the
non-urgent patients signifies a crucial share of the medical workload in the emergency
department , which applied more to the younger generation than the elderly people. It has
been found that the cost of the ED rooms are much higher than the primary care (Uscher-
Pines et al., 2013). The cost of the emergency room are 5-7 time more than that of the normal
rooms in the primary care facilities and also might be due to the fact that most of the primary
care patients do not have to remain overnight. Again, it is the duty of the policy makers to
modify the insurance schemes and the patterns such that the patients under non –urgent care
access the primary care more than the ED.
In conclusion it can be said that an increasing access to the primary care services can
reduce the usage of the resources in the primary care department upto 55% (Raven et al.,
2015). A number of tested measurements that can be recommended are alternative
approaches to primary care services, specialized facilities for the susceptible or the vulnerable
population. Other interventions involves patient education regarding the proper usage of the
ED department. Special urgent care clinics or helpline numbers should be made available to
prevent the non-urgent emergency visits (Schumacher et al., 2013). Financial disincentives

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like higher copayments for the ED visits can also be made. PCP structures should be made in
proximity to the ED, such that patients might access them after the ED triage.

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References
Alyasin, A., & Douglas, C. (2014). Reasons for non-urgent presentations to the emergency
department in Saudi Arabia. International emergency nursing, 22(4), 220-225.
Durand, A. C., Palazzolo, S., Tanti-Hardouin, N., Gerbeaux, P., Sambuc, R., & Gentile, S.
(2012). Nonurgent patients in emergency departments: rational or irresponsible
consumers? Perceptions of professionals and patients. BMC research notes, 5, 525.
doi:10.1186/1756-0500-5-525
Geelhoed, G. C., & de Klerk, N. H. (2012). Emergency department overcrowding, mortality
and the 4-hour rule in Western Australia. Med J Aust, 196(2), 122-6.
Idil, H., Kilic, T. Y., Toker, İ., Turan, K. D., & Yesilaras, M. (2018). Non-urgent adult
patients in the emergency department: Causes and patient characteristics. Turkish
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O’Keeffe, C., Mason, S., Jacques, R., & Nicholl, J. (2018). Characterising non-urgent users
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one, 13(2), e0192855.
Raven, M. C., Kushel, M., Ko, M. J., Penko, J., & Bindman, A. B. (2016). The effectiveness
of emergency department visit reduction programs: a systematic review. Annals of
emergency medicine, 68(4), 467-483.

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Schumacher, J. R., Hall, A. G., Davis, T. C., Arnold, C. L., Bennett, R. D., Wolf, M. S., &
Carden, D. L. (2013). Potentially preventable use of emergency services: the role of
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Uscher-Pines, L., Pines, J., Kellermann, A., Gillen, E., & Mehrotra, A. (2013). Deciding to
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