Fatimah J Al- Shehab, Fatimah M Al- Dakhlan, Zainab Al- Qadheeb, Qasem M. Aljabr


Over the years, the number of visits to emergency departments(ED) increased, resulted in ED crowding and increased waiting times for minor as
well severe problems, a cross-sectional survey was done to investigate this issue at the ERs of the major hospitals in Al-Ahsa,April 2018. This study
aims to analyse the association between inappropriate use of ED services & increasing the average waiting time,to identify the reasons motivating
misuse of the ED And assess patients' knowledge of primary health care (PHC). Interview with 400 patients shows that the average waiting time
was 17 minutes ± 22 SD for urgent case . A high proportion of patients are regularly visiting the ED three to four times/ year .In this study, we tried to
nd the factors that let these patients preferring the ER services even if they know that their cases can be treated in PHCs, limited facilities and
resources was the most affecting factor.
Most of the participant were generally aware of PHCs although 25% were not aware of the services provided by these centres.


Average Waiting Time At Er, Inappropriate Health Seeking Behaviour, Al-ahsa Hospital, Mch, Saudi Arabia.

Full Text:



Afilalo, J., Marinovich, A., Afilalo, M., Colacone, A., Léger, R., Unger, B., & Giguère, C. (2008). Nonurgent Emergency Department Patient Characteristics and Barriers to Primary Care. Academic Emergency Medicine, 11(12), 1302–1310. https://doi.org/doi:10.1197/j.aem.2004.08.032

AL, K. (1994). Nonurgent emergency department visits: Meeting an unmet need. JAMA, 271(24), 1953–1954. Retrieved from http://dx.doi.org/10.1001/jama.1994.03510480077038

Bakarman, M., & K. Njaifan, N. (2014). Assessment of Non-emergency Cases Attending Emergency Department at King Fahad General Hospital, Jeddah;Pattern and Outcomes. Life Science j (Vol. 11).

Bezzina, A. J., Smith, P. B., Cromwell, D., & Eagar, K. (2005). Primary care patients in the emergency department: Who are they? A review of the definition of the ‘primary care patient’ in the emergency department. Emergency Medicine Australasia, 17(5‐6), 472–479. https://doi.org/doi:10.1111/j.1742-6723.2005.00779.x

Billings, J., Parikh, N., & Mijanovich, T. (2000). Emergency department use in New York City: a substitute for primary care? Issue Brief (Commonwealth Fund), (433), 1—5. Retrieved from http://europepmc.org/abstract/MED/11665698

Carret, M., Fassa, A., & Kawachi, I. (2007). Demand for emergency health service: factors associated with inappropriate use. BMC Health Services Research, 7, 131. https://doi.org/10.1186/1472-6963-7-131

Carret, M. L. V., Fassa, A. C. G., & Domingues, M. R. (2009). Inappropriate use of emergency services: a systematic review of prevalence and associated factors. Cadernos de Saude Publica, 25(1), 7–28.

Dawoud, S. O., Ahmad, A. M. K., Alsharqi, O. Z., & Al-Raddadi, R. M. (2016). Utilization of the Emergency Department and Predicting Factors Associated With Its Use at the Saudi Ministry of Health General Hospitals. Global Journal of Health Science, 8(1), 90–106. https://doi.org/10.5539/gjhs.v8n1p90

Elkum, N. B., Barrett, C., & Al-Omran, H. (2011). Canadian Emergency DepartmentTriage and Acuity Scale: implementation in a tertiary care center in Saudi Arabia. BMC Emergency Medicine, 11, 3. https://doi.org/10.1186/1471-227X-11-3

Hing, E., & Bhuiya, F. (2012). Wait time for treatment in hospital emergency departments: 2009. NCHS Data Brief, (102), 1–8.

Koziol-McLain, J., Price, D. W., Weiss, B., Quinn, A. A., & Honigman, B. (2000). Seeking care for nonurgent medical conditions in the emergency department: through the eyes of the patient. Journal of Emergency Nursing: JEN : Official Publication of the Emergency Department Nurses Association, 26(6), 554–563. https://doi.org/10.1067/men.2000.110904

Lambe, S., Washington, D. L., Fink, A., Laouri, M., Liu, H., Fosse, J. S., … Asch, S. M. (2003). Waiting times in California’s emergency departments. Annals of Emergency Medicine, 41(1), 35–44. https://doi.org/10.1067/mem.2003.2

Lang, T., Davido, A., Diakite, B., Agay, E., Viel, J. F., & Flicoteaux, B. (1997). Using the hospital emergency department as a regular source of care. European Journal of Epidemiology, 13(2), 223–228.

Lee, A., Lau, F.-L., Hazlett, C. B., Kam, C.-W., Wong, P., Wong, T.-W., & Chow, S. (2000). Factors associated with non-urgent utilization of Accident and Emergency services: a case-control study in Hong Kong. Social Science & Medicine, 51(7), 1075–1085. https://doi.org/https://doi.org/10.1016/S0277-9536(00)00039-3

Medicare, C., & Services, M. (2014). Hospital Compare Downloadable Database Data Dictionary.

Murray, M., Bullard, M., & Grafstein, E. (2004). Revisions to the Canadian Emergency Department Triage and Acuity Scale implementation guidelines. CJEM, 6(6), 421–427.

Northington, W. E., Brice, J. H., & Zou, B. (2005). Use of an emergency department by nonurgent patients. The American Journal of Emergency Medicine, 23(2), 131–137. https://doi.org/10.1016/j.ajem.2004.05.006

Oktay, C., Cete, Y., Eray, O., Pekdemir, M., & Gunerli, A. (2003). Appropriateness of emergency department visits in a Turkish university hospital. Croatian Medical Journal, 44(5), 585–591.

Porro, F., Folli, C., & Monzani, V. (2013). Reasons for inappropriate attendance of the Emergency Room in a large metropolitan hospital. European Journal of Internal Medicine, 24(2), e13–e14. https://doi.org/10.1016/j.ejim.2012.11.016

Redstone, P., Vancura, J. L., Barry, D., & Kutner, J. S. (2008). Nonurgent Use of the Emergency Department. The Journal of Ambulatory Care Management, 31(4). Retrieved from https://journals.lww.com/ambulatorycaremanagement/Fulltext/2008/10000/Nonurgent_Use_of_the_Emergency_Department.8.aspx

Sempere-Selva, T., Peiró, S., Sendra-Pina, P., Martínez-Espín, C., & López-Aguilera, I. (2001). Inappropriate use of an accident and emergency department: Magnitude, associated factors, and reasons - An approach with explicit criteria. Annals of Emergency Medicine, 37(6), 568–579. https://doi.org/10.1067/mem.2001.113464

Shah, N. M., Shah, M. A., & Jaafar, B. (1996). Predictors of non-urgent utilization of hospital emergency services in Kuwait. Social Science & Medicine, 42(9), 1313–1323. https://doi.org/https://doi.org/10.1016/0277-9536(95)00233-2

Stein, A. T., Harzheim, E., Costa, M., Busnello, E., & Rodrigues, L. C. (2002). The relevance of continuity of care: a solution for the chaos in the emergency services. Family Practice, 19(2), 207–210. Retrieved from http://dx.doi.org/10.1093/fampra/19.2.207

Tsai, J. C. H., Liang, Y. W., & Pearson, W. S. (2010). Utilization of emergency department in patients with non-urgent medical problems: Patient preference and emergency department convenience. Journal of the Formosan Medical Association, 109(7), 533–542. https://doi.org/10.1016/S0929-6646(10)60088-5

United States Government Accountability Office. (2009). Hospital Emergency Departments: Crowding Continues to Occur, and Some Patients Wait Longer than Recommended Time Frames Highlights, (April), 58.

Wilper, A. P., Woolhandler, S., Lasser, K. E., McCormick, D., Cutrona, S. L., Bor, D. H., & Himmelstein, D. U. (2008). Waits to see an emergency department physician: U.S. trends and predictors, 1997-2004. Health Affairs (Project Hope), 27(2), w84-95. https://doi.org/10.1377/hlthaff.27.2.w84


  • There are currently no refbacks.