1887
Volume 2014, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

The use of emergency department (ED) services for non-urgent conditions is well-studied in many Western countries but much less so in the Middle East and Gulf region. While the consequences are universal—a drain on ED resources and poor patient outcomes—the causes and solutions are likely to be region and country specific. Unique social and economic circumstances also create gender-specific motivations for patient attendance. Alleviating demand on ED services requires understanding these circumstances, as past studies have shown. We undertook this study to understand why female patients with low-acuity conditions choose the emergency department in Qatar over other healthcare options. Prospective study at Hamad General Hospital's (HGH) emergency department female “see-and-treat” unit that treats low-acuity cases. One hundred female patients were purposively recruited to participate in the study. Three trained physicians conducted semi-structured interviews with patients over a three-month period after they had been treated and given informed consent. The study found that motivations for ED attendance were systematically influenced by employment status as an expatriate worker. Forty percent of the sample had been directed to the ED by their employers, and the vast majority (89%) of this group cited employer preference as the primary reason for choosing the ED. The interviews revealed that a major obstacle to workers using alternative facilities was the lack of a government-issued health card, which is available to all citizens and residents at a nominal rate. Reducing the number of low-acuity cases in the emergency department at HGH will require interventions aimed at encouraging patients with non-urgent conditions to use alternative healthcare facilities. Potential interventions include policy changes that require employers to either provide workers with a health card or compel employees to acquire one for themselves.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2014.16
2015-01-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2014/2/qmj.2014.16.html?itemId=/content/journals/10.5339/qmj.2014.16&mimeType=html&fmt=ahah

References

  1. Raven MC, Lowe RA, Maselli J, Hsia RY. Comparison of presenting complaint vs discharge diagnosis for identifying “nonemergency” emergency department visits. JAMA 20 2013; 309::11451153.
    [Google Scholar]
  2. Chmiel C, Huber CA, Rosemann T, Zoller M, Eichler K, Sidler P, Senn O. Walk-ins seeking treatment at an emergency department or general practitioner out-of-hours service: A cross-sectional comparison. BMC Health Serv Res. 2011; 11::94.
    [Google Scholar]
  3. Morris ZS, Boyle A, Beniuk K, Robinson S. Emergency department crowding: Towards an agenda for evidence-based intervention. Emerg Med J. 2012; 29::460466.
    [Google Scholar]
  4. Carlson JN, Menegazzi JJ, Callaway CW. Magnitude of national ED visits and resource utilization by the uninsured. Am J Emerg Med. 2013; 31::722726.
    [Google Scholar]
  5. Nagree Y, Camarda V, Fatovich D, Cameron P, Dey I, Gosbell A, McCarthy S, Mountain D. Quantifying the proportion of general practice and low-acuity patients in the emergency department. Med J Aust. 2013; 198::612615.
    [Google Scholar]
  6. Statistics Authority. Qatar Population Status 2012: Three Years After Launching the Population Policy, State of Qatar.
  7. Morgans A, Burgess S. Judging a patient's decision to seek emergency healthcare: Clues for managing increasing patient demand. Aust Health Rev. 2012; 36::110114.
    [Google Scholar]
  8. Read JG, Gorman B. Gender and health inequality. Ann Rev Soc. 2010; 36::371386.
    [Google Scholar]
  9. Statistics 2012, Hamad General Hospital Emergency Department.
  10. Hospital Episode Statistics: Accident and Emergency Attendances in England 2011-2012. Summary Report, Health and Social Care Information Centre http://www.hscic.gov.uk/catalogue/PUB09624 .
  11. Xu M, Wong TC, Wong SY, Chin KS, Tsui KL, Hsia RY. Delays in service for non-emergent patients due to arrival of emergent patients in the emergency department: A case study in Hong Kong. J Emerg Med. 2013; 45::271280.
    [Google Scholar]
  12. Schull MJ, Kiss A, Szalai JP. The effect of low-complexity patients on emergency department waiting times. Ann Emerg Med. 2007; 49::257264.
    [Google Scholar]
  13. Higginson I. Emergency department crowding. Emerg Med J. 2012; 29::437443.
    [Google Scholar]
  14. Alyasin A, Douglas C. Reasons for non-urgent presentations to the emergency department in Saudi Arabia. Int Emerg Nurs. 2014;, In press.
    [Google Scholar]
  15. Morgans A, Burgess S. Judging a patient's decision to seek emergency healthcare: Clues for managing increasing patient demand. Aust Health Rev. 2012; 36::110114.
    [Google Scholar]
  16. Supreme Council of Health. 2013. Website accessed on June 20, 2014. http://www.hamad.qa/en/hcp/healthcare_in_qatar/supreme_council_of_health/supreme_council_of_health.aspx .
  17. Tuma MA, Acerra JR, El-Menyar A, Al-Thani H, Al-Hassani A, Recicar JF, Al Yazeedi W, Maull KI. Epidemiology of workplace-related fall from height and cost of trauma care in Qatar. Int J Crit Illn Inj Sci. 2013; 3::37.
    [Google Scholar]
  18. Qatar National Health Accounts—1st Report 2009-2010. 2011. A Baseline Analysis of Healthcare Expenditure and Utilization, Supreme Council of Health .
  19. Hoot NR, Aronsky D. Systematic review of emergency department crowding: Causes, effects, and solutions. Ann Emerg Med. 2008; 52::126136.
    [Google Scholar]
  20. Ragin DF, Hwang U, Cydulka RK, Holson D, Haley LL, Richards CF, Becker BM, Richardson LD, Reasons for Using the Emergency Department: Results of the EMPATH Study, 2005.
  21. Masso M, Bezzina A, Siminski P, Middleton R, Eager K. Why patients attend emergency departments for conditions potentially appropriate for primary care: Reasons given by patients and clinicians differ. Emerg Med Aust. 2007; 19::333340.
    [Google Scholar]
  22. Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Emergency department visits for nonurgent conditions: Systematic literature review. Am J Mngd Care. 2013; 19::4759.
    [Google Scholar]
  23. Pines J, Hilton J, Weber E, Weber E, Alkemade AJ, Al Shabanah H, Anderson PD, Bernhard M, Bertini A, Gries A, Ferrandiz S, Kumar VA, Harjola VP, Hogan B, Madsen B, S , G , Rainer T, Rathlev N, Revue E, Richardson D, Sattarian M, Schull MJ. International perspectives on emergency department crowding. Acad Emerg Med. 2011; 18::13581370.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2014.16
Loading
/content/journals/10.5339/qmj.2014.16
Loading

Data & Media loading...

Supplements

Supplementary File 1

  • Article Type: Research Article
Keyword(s): emergency department overcrowdingemergency medicinefemale patients and policy implications
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error