However, despite availability, the patients avoid PHCCs for reasons, such as long distance, long waiting time, difficulty in getting an appointment, and shortage of resources. 10–12 Thus, PHCCs, general practitioners (GPs), and family medicine specialists must play a significant role in reducing non-urgent visits. 9 In contrast, individuals with regular physician visits showed a 40–67% reduction in inappropriate ED use. 7, 8 In Saudi Arabia, the number is as high as 78.5%. Even in developed countries, such as France and the United States, there is evidence of an increase in non-urgent ED visits (44.9% and 13.7–27.1%, respectively). 5 Uthman et al 6 revealed that 6.7–89% of ED visits are non-urgent this large discrepancy is due to the varying definitions of non-urgent cases among researchers. Other recognized factors found in Saudi Arabia includes the low cost of ED services, inappropriate referrals from other specialties, and overcrowding in other departments. Occasionally, the patients overestimate the urgency of their condition or are poorly aware of the scope of ED and primary healthcare center (PHCC) services. For example, the patients may want rapid, convenient, and well-equipped, specialized ED services. Inappropriate ED visits are a global public health problem, and there are different reasons that account for these visits. It also compels the ED to provide more complex and prolonged care than usual, leading to reduced care quality and an increased risk of adverse outcomes. 3 The ultimate result is the overcrowding of patients in the ED and a longer waiting time. Such use negatively affects the quality of patient care as well as the satisfaction of patients and ED staff. The use of EDs by non-urgent patients has become an important public health burden both locally and globally. The first three levels include the cases that require resuscitation, emergent cases, or urgent cases, while the fourth and fifth levels represent the less- or non-urgent cases, respectively. 2 As per the CTAS, healthcare providers categorize ED patients into a five-level triage system according to their conditions. For over 16 years, most hospitals in Saudi Arabia have adhered to the Canadian Triage and Acuity Scale (CTAS). This triage system distinguishes urgent from non-urgent patients, and increases the quality of care for the patients who require urgent care. 1 In an ED, patients are prioritized based on triage categories, where urgent cases are admitted to the ED immediately and non-urgent cases are taken to the waiting room and are examined in turns. Emergency departments (EDs) are designed to provide rapid, accessible, high-quality, and unscheduled care for urgent and emergency cases.
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