Non-urgent consultations in polyvalent emergency department: proportion and contributing factors

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Published Feb 15, 2026
https://doi.org/10.62438/tunismed.v103i12.5872
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Vol. 103 No. 12 (2025): Tunis Med Dec 2025

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Fatma Hebaieb
Department of Emergency Medicine, Internal Security Forces Hospital, La Marsa, Faculty of Medicine of Tunis, UniversityTunis El Manar, 1007,Tunis , Tunisia
Yousra Ayachi
Department of Family and Community Medicine, Sousse , University of Sousse, Faculty of Medicine of Sousse, 4002, Tunisia
Imen Naggara
Department of Emergency Medicine, Internal Security Forces Hospital, La Marsa, Faculty of Medicine of Tunis, UniversityTunis El Manar, 1007,Tunis , Tunisia
Saloua Houimli
Department of Emergency Medicine, Internal Security Forces Hospital, La Marsa, Faculty of Medicine of Tunis, UniversityTunis El Manar, 1007,Tunis , Tunisia
Jihène Sahli
Department of Family and Community Medicine, Sousse , University of Sousse, Faculty of Medicine of Sousse, 4002, Tunisia

Abstract

I


Introduction:Overcrowding in emergency departments (EDs) is a concerning global problem with negative repercussions for patients and caregivers. It is partly due to non-urgent consultations. The aims of our study wereto determine the proportion of non-urgent ED visits and to identify factorsassociated.


Methods: Cross-sectional study with an analytical aim including patients aged over 15 years consulted a polyvalent ED during14-day period. Consultations were coded from 1 to 5 according to the Clinical Classification of Emergency Patients (CCMU). We compared 2 groups: group 1 with urgent consultation (CCMU 3,4 and 5) and group 2 with non-urgent consultation (classified CCMU 1 and 2).


Results: N= 589, mean age=42years with a female predominance (54.5%). Group 1 included 149 patients and the second Group 440 patients (74.7%). Patients were significantly younger in group 2 and 60.8% had social security coverage (p=0.006). Reasons that motivated the EDvisitwereproximity, search for a quick solution and ignorance of the appropriate health facility to attend (p<0.05). Independent factors of non-urgent ED visit were single status, self-referral to the ED, perception of the symptom as not severe, no attending physician, no history of similar symptoms, search for a quick solution, and patient-perceived need for further investigations.


Conclusion:Easy access to investigations in EDs leads patients to consult them for non-urgent reasons. Better communication between them and basic health centers is recommended for the management of patients in CCMU 1 and 2 to avoid ED overload.

Keywords:

Emergency Medical Services, Referral and Consultation, Ambulatory Care Facilities, non-urgent , Factors

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