Factors that contribute to non-urgent utilization of emergency services in the Eastern Province of Saudi Arabia

Abstract

BACKGROUND:
The utilization of the Emergency Department (ED) for non-urgent care poses a major problem to the healthcare system. The objective of the study was to assess non-urgent visits to ED and determine the factors influencing non-urgent visits to the ED.


MATERIALS AND METHODS:
A cross-sectional study was conducted at a secondary level hospital in the Eastern Province of Saudi Arabia from October 2024 to February 2025. Study included 412 Canadian Triage and Acuity Scale (CTAS) IV and V patients. Data was collected by interviewing the patients or their relative using a validated structured questionnaire. Data was analyzed using SPSS version 29; categorical data was presented as frequencies and percentages. Chi-square test or Fisher’s exact test, as appropriate, was used to determine association between non-urgent ED visit and various factors. Multiple logistic regression analysis was performed to identify predictors of non-urgent ED visits.


RESULTS:
Majority of the patients were Saudis (85.0%), more than half (55.8%) were female, and more than one-third (38.1%) were aged 20-34 years. Common presenting complaints included abdominal pain (20.9%), cold/flu symptoms (10.4%), and back/leg pain (8.7%); Most patients (46.8%) reported symptoms lasting <1 week. At univariate analysis, non-urgent ED visits were significantly associated with age (P = 0.049) and region of residence (P = 0.018). Logistic regression showed weak association between non-urgent ED visit and marital status, employment, type of accommodation, and presence of a chronic disease but these were not statistically significant (P > 0.05). Accessibility (43.4%) and perceived urgency (41.0%) were key drivers for the preference of the ED to primary care.


CONCLUSION:
The study highlights key factors that influence non-urgent visits, with accessibility and perceived urgency being the primary drivers. Findings highlight the need to improve primary healthcare access and triage awareness to reduce unnecessary ED visits.