Factors affecting the non‐urgent consultations in the emergency department of a tertiary hospital in the Philippines: A cross‐sectional study

• Published in: Emergency medicine Australasia Vol. 33; no. 2; pp. 349 - 356
• Main Authors: Jimenez, Ma Lourdes CD, Manzanera, Rafael, Carascal, Mark B, Figueras, Marlouie DL, Wong, John Q, Moya, Diego, Mira, Jose J
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.04.2021
• Subjects: emergency department; non‐urgent; Philippines; triage; urgent; non-urgent; emergency department; urgent; triage; Philippines
• ISSN: 1742-6731; 1742-6723
• DOI: 10.1111/1742-6723.13725

Objectives The non‐standard emergency medicine services and the limited utilisation of primary care providers in the Philippines may contribute towards the ED being a preferred area for patients with non‐urgent conditions. Our study aims to determine the factors associated with non‐urgent consultations in the ED of a tertiary hospital in the Philippines. Methods From 7 January to 15 February 2020, we surveyed non‐urgent ED patients (n = 757) presenting to a tertiary hospital in the Philippines. We evaluated the data using descriptive statistics, while chi‐squared and multivariate analyses versus urgent ED patients (n = 281) were used to show the association of factors. Results Our recruited non‐urgent patients were mostly 21–40 years old (n = 576 [76%]), single (n = 437 [58%]), with full‐time employment (n = 654 [86%]), have Health Maintenance Organization coverage (n = 684 [90%]), self‐referred (n = 498 [66%]), and have private means of getting to ED (n = 414 [55%]). They had moderate scores of social support‐seeking behaviours (mean 3.92/5; 95% confidence interval [CI] 3.88–3.96), health literacy (mean 3.58/5; 95% CI 3.56–3.61), self‐efficacy (mean 3.09/5; 95% CI 3.56–3.61), whereas their ED access score (mean 4.10/5; 95% CI 4.06–4.14) was high. They had moderate self‐assessed severity (mean 3.75/6; 95% CI 3.70–3.80), urgency (mean 3.83/6; 95% CI 3.78–3.88), and anxiety (mean 3.88/6; 95% CI 3.83–3.93) scores and high ED satisfaction rating (mean 4.73/6; 95% CI 4.69–4.77). They mostly had digestive (n = 203 [26.8%]) and infection‐related (n = 172 [22.7%]) chief complaints and final diagnoses (n = 198 [26.2%] and n = 145 [19.2%], respectively), without previous consultations (n = 577 [76%]), and eventually discharged (n = 755 [99%]). Our urgent patients had similar characteristics, but with higher assessed patient severity, urgency, anxiety and satisfaction with ED services (P < 0.001). Conclusion Non‐urgent consultations in ED are attributed to multiple factors encompassing socio‐demographic, socio‐economic and psychosocial dimensions. These factors must be considered in improving the current healthcare management system for the appropriate utilisation of ED in the Philippines. Non‐urgent consultations in ED are attributed to multiple factors encompassing socio‐demographic, socio‐economic and psychosocial dimensions. These factors must be considered in improving the current healthcare management system for the appropriate utilisation of ED in the Philippines.