A retrospective study on emergency visits in two hospitals in Sherbrooke, Canada

Abstract

Non-urgent use of Emergency Departments throughout Canada has long presented a conundrum for hospital admini-
strators and health service planners. On the one hand, perceptions persist that those non-urgent users contribute to overcrowding, higher costs of care and longer wait times. On the other hand, non-urgent users do not appear to increase wait times for high-acuity patients; they perceive their condition to be acute, or claim not having convenient access to primary medical services. The objective of this study is to investigate factors associated with emergency demand for minor conditions using administrative data as well as geographical and socioeconomic characteristics as captured by Pampalon’s deprivation indexes. We reviewed 42 months of administrative data (2006 – 2009) of minor emergency visits in two hospitals in Sherbrooke, QC, Canada. Data mining algorithms were applied to classify the visits and detect major utilization patterns of Sherbrooke residents. Lower priority visits (CTAS 5) continued to increase in the city hospital following a remodel. Adult residents tend to choose the closest ED, and children mainly go to the regional hospital ED. The use of ED for minor conditions (CTAS level 4 and 5) was higher in the most deprived communities, whether materially or socially. The most common diagnostic codes were injuries and poisoning, ill-defined conditions, respiratory problems, digestive system problems, musculoskeletal, and mental health conditions, with 15% of the visits not completed because patients left before seeing a doctor. Two Sherbrooke boroughs, with no walk-in clinics, generated the majority (57%) of all non-urgent visits. We forecast the reduction in the number of visits to ED if two walk-in clinics were opened in these boroughs.