Nearly 1 in 5 Patient Visits to Emergency Could Potentially Be Treated Elsewhere

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Nearly 1 in 5 Patient Visits to Emergency Could Potentially Be Treated Elsewhere

November 6, 2014—A new study by the Canadian Institute for Health Information (CIHI) identified that about 1 in 5 patients visited the emergency department (ED) for conditions that could be treated in a family practice setting or that are potentially preventable.

The study, Sources of Potentially Avoidable Emergency Department Visits, focused on 2 groups of patients: those who use the ED for minor conditions not requiring hospitalization; and seniors who live in long-term care (LTC) residences.

With approximately 17 million visits to EDs across the country in 2013–2014, Canadians are among the most frequent users of EDs in the world, compared with countries such as Australia, the United States and the United Kingdom.

“A visit to the ED is not always preventable and many times it is the best place to go for care,” said Dr. Jeremy Veillard, Vice President, Research and Analysis, CIHI. “If we can identify cases where patients can be treated in more appropriate settings and provide them with access to alternative care options, it will benefit patients and their families and reduce the pressure on emergency departments.”

Patients with minor medical conditions

Young children had the highest rates of ED visits for minor medical conditions compared with people of other ages. Upper respiratory infection and otitis media (ear infection) are among the top reasons for bringing children younger than age 5 to the ED. ED visits for minor medical conditions were also more common among people who live in rural areas.

In a general cross-Canada survey conducted for this study, 47% of respondents said they chose to go to the ED because they could not get a timely appointment with a family physician.

“Parents might choose to bring their child to the ED instead of waiting for an appointment with a family doctor,” says Kathleen Morris, Director, Health System Analysis and Emerging Issues. “In rural Canada, the ED may be the only place to receive treatments that are performed in family practice settings in urban areas.”

Long-term care patients

Seniors in LTC facilities represent less than 1% of ED visitors. However, as this group has round-the-clock access to basic care and treatment, some of these visits may have been better addressed on site.

“Going to the ED can be a difficult experience for long-term care patients,” explains Morris. “Many of them suffer from cognitive impairment such as dementia, and their health status is often complex. The transfer from residence to ED can be stressful on the patient and family members. It also creates a break in continuity of care.”

The data shows that about 1 in 3 ED visits among seniors living in LTC is potentially avoidable. The most common reasons for these avoidable visits are urinary tract infections, pneumonia and falls. With earlier diagnosis and improved access to on-site treatment, some of these conditions could be managed at the facility and a visit to the ED avoided altogether.

Additional information

The data used to complete this study was submitted to CIHI’s National Ambulatory Care Reporting System (NACRS). NACRS captures approximately 60% of all ED visits in Canada. 2013–2014 data on ED utilization is now available on our Quick Stats page.

An infographic has been prepared to help you understand sources of ED visits from the 2 groups of patients observed in this study.


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