Accessibility to primary health care and emergency department visits

Abstract

Background: It is widely acknowledged in many countries that the delivery of accessible primary health care (PHC) is one of the most important national priorities. On the other hand, frequent complaints relating to longer waits to access hospital care and overutilization of emergency services are still common. Objectives: The objective of this study was to determine patients' accessibility to PHC nonurgent emergency department (ED) and its influence factors to improve primary care quality and reduce ED crowding. Subjects and Methods: This was an observational cross-sectional study. Convenience sample of ED patients was chosen from the Prince Sultan Military Medical City hospital ED in Riyadh, Saudi Arabia. An interview questionnaire was designed to collect the data. The data were analyzed using SPSS software, version 24. Results: A total of 89 nonurgent ED patients participated in this study and their mean age was 36.45 (standard deviation = 14.8). Most of the participants (70.8%) were male and half of them (51.7%) had “secondary or diploma” degree. Most of the participants (85.4%) mentioned that they never visited PHCs. Almost half of the participants (51.7%) mentioned that they visited ED only one time in the last 12 months. About fifth (20.2%) of the patients mentioned that they did not access to PHC due to long waiting in the doctor's office. Patients' education status and duration of presenting complaint were significantly associated with their trying to go to PHC and visiting ED in the last year. Conclusion: According to the results of this study, it is necessary to develop strategies to implement policies aimed at reducing nonurgent ER use as well as make health-care services more available to the population.