Emergency departments (EDs) provide time-critical care for acute and potentially life-threatening conditions such as myocardial infarction, stroke, sepsis, severe trauma, and acute respiratory failure. However, increasing use of EDs for non-urgent conditions has been widely reported and is associated with operational pressure on emergency care systems. This systematic review examines key factors associated with adult use of EDs for non-urgent conditions and summarizes the reported impact on emergency care delivery and health systems. A structured literature search was conducted using PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, and Google Scholar to identify English-language studies published between 2004 and 2024. Studies focusing on adult non-urgent ED utilization were selected based on predefined inclusion criteria and synthesized using a narrative approach due to heterogeneity in study designs, healthcare settings, and definitions of non-urgent visits. Across included studies, 44% of non-urgent ED visits were made by individuals aged 16-35 years, while elderly patients (>65 years) accounted for approximately 2-3%. Non-urgent attendance was commonly associated with low health literacy, such as the belief that EDs provide faster care than primary care, misunderstanding that EDs are the only option for uninsured patients, and a lack of awareness of urgent care clinics and limited awareness of alternative care options, such as telehealth alternatives. Geographic disparities, limited after-hours availability, and delays in primary care services significantly influence ED use. Socioeconomic factors, including low income, lack of insurance, and employment constraints, were also frequently reported. Non-urgent ED visits were seen to be associated with increased crowding and resource strain, potentially contributing to longer waiting times for higher-acuity patients and reduced efficiency of emergency care delivery. Reported strategies include expanding after-hours primary care services, improving public education on appropriate healthcare use, and optimizing ED resource management. Future research should prioritize standardized definitions of non-urgent visits and evaluate interventions across diverse healthcare systems.
Alayob et al. (Mon,) studied this question.