Nonurgent patient use of the emergency department

Increased use of emergency departments (EDs) for nonurgent primary care, overcrowding, and cost factors has forced healthcare systems to promote more 'appropriate' use of the ED. However, few studies have evaluated patients' perceptions of urgency and why they utilize the ED for medical care. This preliminary descriptive study evaluated the utilization of the ED for nonurgent healthcare problems. Forty-six subjects were surveyed prospectively regarding their perceptions of the urgency of their presenting complaints during nonurgent ED visits. Physicians rated the subjects' level of urgency prospectively and retrospectively. The study evaluated patient characteristics and factors that influence the use of the ED. The patients' perceptions of urgency were higher overall than the physicians' prospective and retrospective ratings. Subjects' ratings of urgency were 48% urgent, 18% prompt, and 34% delayed. Physicians rated subjects' urgency prospectively (28% urgent, 26% prompt, and 46% delayed) and retrospectively (26% urgent, 15% prompt, and 59% delayed).