Non-Urgent Pediatric Presentations to the Emergency Department, Khamis Mushayt Maternity and Children Hospital, Saudi Arabia

Abstract

Aim of Study: To explore parents’ perspectives regarding why parents (caregivers) prefer to escort their less urgent, or non-urgent sick children to the emergency departments (EDs) instead of using other more appropriate healthcare services. Methods: This study followed a quantitative cross-sectional design at Khamis Mushayt Maternity and Children’s Hospital (KMMCH). A study questionnaire was designed by the researchers to interview parents of 400 children who inappropriately attended the ED to identify the reasons for their inappropriate attendance at the ED. Data collection was performed during the period of January 2023 to explore the proportions of different attendances that were deemed inappropriate according to the hospital’s followed triage system. The interviews were conducted with parents/caregivers of non-urgent and less urgent children during their waiting times. Results: The age of 18.3% of parents was <30 years, while 28.5% were 30-39 years old. More than half of the parents’ visits were non-urgent, while 43.25% were less-urgent, 55.3% of patients visited the ED before due to similar complaints, while 46% visited a primary health care center before their ED visits. The main reasons for visiting the ED instead of the primary healthcare centers (PHCCs) were to save time (49.3%) and to get an earlier appointment (48%). Patients’ triage levels differed significantly according to parents’ age groups (p<0.001), nationality (p=0.022), educational level (p=0.022), ED visits for similar complaints (p<0.001), and previously visiting the PHCC for the current health problem (p=0.002). Triage levels also differed significantly according to some reasons for choosing to go to the ED instead of the PHCC, especially to get an earlier appointment (p=0.044), preferring the healthcare services provided by the ED (p=0.005), having a nearby ED (p=0.001), or being at the hospital at that time (p=0.002). Conclusions: There is a clear relationship between inappropriate ED visits and certain associated factors, indicating that prevention would be best targeted to certain categories, such as Saudi, younger, and educated parents. The main reasons for inappropriate ED visits are to save time and to avoid getting a late appointment. Recommendations: This study emphasized the importance of implementing proper health education and redirection of patients with inappropriate ED visits. Conducting a detailed analysis of the shortages in the utilization of primary healthcare resources is a pressing necessity. Further nationwide research on patients’ perspective for non-urgent ED presentations is largely needed. Key Words: Emergency Department, Triage, Children, Non-urgent level, Less urgent level.