Recent trends in global healthcare reveal a concerning pattern of patients utilizing Emergency Departments (EDs) for non-urgent medical issues. This phenomenon not only strains hospital resources but also points to underlying issues in healthcare accessibility. As healthcare systems in both high- and middle-income countries grapple with this challenge, understanding the role of distance in ED utilization could inform future healthcare policies aimed at mitigating this trend.
Study Objective and Methodology
A systematic review was undertaken to explore the relationship between distance to healthcare facilities and the use of EDs for non-urgent cases. The review adhered to a registered protocol (PROSPERO: CRD42023398674) and analyzed data from five databases as of 22 August 2023. The selected studies were evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework to ensure high-quality evidence. Studies involving ambulance transport, referrals from other hospitals, or measuring distance from other facilities were excluded to maintain focus on primary ED visits.
Key Findings
Out of the fifteen articles that met the inclusion criteria, over half demonstrated a moderate level of evidence showing an inverse relationship between distance and ED visits for non-urgent conditions. Specifically, eight studies—including one pediatric, four all-ages/adult, and three ecological—highlighted this connection, whereas the remaining studies presented weaker evidence. These findings underscore the significant influence of accessibility on the decision to seek emergency care for non-urgent health issues.
Practical Implications
Healthcare policymakers might consider the following insights to address the issue effectively:
- Implementing more localized primary care facilities to reduce non-urgent ED visits.
- Enhancing public awareness about appropriate ED usage and alternative healthcare options.
- Improving transportation infrastructure to facilitate access to non-emergency medical services.
- Employing telehealth solutions to provide remote consultations, thereby alleviating the need for physical ED visits.
The research highlights the necessity for targeted strategies to manage ED utilization, which could ultimately lead to better resource allocation and improved patient outcomes.
In conclusion, the study reveals that shorter distances to EDs are often associated with higher rates of non-urgent visits. These insights are crucial for shaping healthcare policies aimed at minimizing unnecessary ED use and ensuring that emergency services are reserved for genuine emergencies.
Original Article: Glob Health Action. 2024 Dec 31;17(1):2353994. doi: 10.1080/16549716.2024.2353994. Epub 2024 Jun 3.
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