Frequent Use Of Emergency Department In Saudi Public Hospita

FREQUENT USE OF EMERGENCY DEPARTMENT IN SAUDI PUBLIC HOSPITAL: IMPLICATION FOR PRIMARY HEALTH CARE SERVICES

Saudi Arabia faces a wide range of chronic conditions burden. Despite the increasing number of primary health care centers (PHCCs) across the kingdom, access and utilization remain uneven, particularly in rural areas. Limited evidence exists regarding the barriers and facilitators influencing primary healthcare access. Frequent use of emergency departments (ED) in Saudi public hospitals is a significant concern, with individuals making numerous visits within a specified period. Although definitions vary, frequent ED users tend to be individuals with low socioeconomic status and both mental and physical health issues, contributing disproportionately to overall ED visits (Alghanim & Alomar, 2015).

Overcrowding caused by frequent ED visitors compromises the quality of care. However, there is a paucity of literature detailing the statistical tools employed to analyze the characteristics and predictors of frequent ED users. Understanding these tools is essential for developing interventions to mitigate ED overcrowding. This research aims to identify and evaluate the statistical methods used in analyzing variables associated with frequent ED use and explore factors affecting the accessibility and utilization of primary healthcare services in Riyadh's urban and rural regions.

The study will focus on Riyadh Province, selecting five regions with the highest and lowest population densities, respectively. A mixed-methods approach will be employed, including a scoping review following a five-stage framework and primary data collection through surveys and public health surveillance data. Variables such as age, region, income, and gender will be assessed as potential predictors of frequent ED use and primary care utilization. Despite the presence of PHCCs, shortages of resources like beds and healthcare professionals, especially in Riyadh, exacerbate healthcare access issues. The influx of non-Saudi workers and the migration of Saudi healthcare professionals further strain the system (Alfaqeeh et al., 2017).

Distance to healthcare facilities emerges as a significant barrier, especially in rural areas. Patients in these regions often face difficulties accessing primary care due to transportation challenges, unlike those living in urban centers where services are more readily available. Patient satisfaction with public hospital services is reportedly low, often linked to poor patient care, limited service hours, and the absence of appointment booking systems, leading to overcrowding and decreased care quality (Abuhammad & Dalky, 2019). The study will investigate whether appointment systems and operational hours influence primary care access and usage.

Recommendations from this research include increasing the number of PHCCs and healthcare professionals to reduce ED frequent visits, especially in underserved rural areas. Policymakers need to prioritize resource allocation, staffing, and infrastructure improvements to enhance service quality and accessibility. Additionally, implementing efficient appointment systems and expanding operating hours could significantly improve primary care utilization and reduce ED overcrowding. Better understanding of these factors will guide strategic planning to improve Saudi Arabia’s healthcare system, ensuring equitable and high-quality care.

Paper For Above instruction

Saudi Arabia's healthcare system faces ongoing challenges related to the equitable distribution and accessibility of primary health care services, especially amidst increasing population demands and the persistent issue of emergency department overcrowding. The phenomenon of frequent ED utilization plays a critical role in straining hospital resources, compromising care quality, and exposing systemic inefficiencies. Addressing this issue necessitates a thorough understanding of the predictors and characteristics of frequent ED users, alongside the barriers to utilizing primary healthcare effectively in both urban and rural settings.

The landscape of healthcare utilization in Saudi Arabia is characterized by disparities driven by geographical, socioeconomic, and infrastructural factors. Rural areas, in particular, suffer from inadequate healthcare resources, limited access, and high transportation barriers, which increase reliance on ED services as a primary point of care. In contrast, urban centers like Riyadh are better equipped but still face issues such as overcrowding and resource shortages. The imbalance is further exacerbated by workforce migration and staffing shortages, reducing the system’s capacity to meet patient needs efficiently.

Research indicates that frequent ED users tend to be individuals with chronic illnesses, mental health issues, or low socioeconomic status. These populations are more likely to utilize ED services repeatedly due to barriers in accessing primary care, including long distances, limited operational hours, and appointment unavailability (Alghanim & Alomar, 2015). Consequently, these patients often present with advanced health issues, necessitating urgent care, which sustains a cycle of recurrent ED visits. This pattern underscores the importance of targeted interventions to identify high-risk groups and tailor services accordingly.

One of the critical factors influencing healthcare utilization is geographic accessibility. Studies have consistently shown that distance is a formidable barrier, especially in rural regions where healthcare facilities are sparse. Transportation challenges and lack of awareness further hinder access to timely primary care, forcing residents to seek care in EDs for non-emergency issues. Conversely, urban residents benefit from denser healthcare networks, though they are not immune to overcrowding and resource limitations.

Addressing these disparities requires strategic resource deployment, including increasing the number of PHCCs and healthcare providers, especially in underserved areas. The Saudi government has committed to expanding primary healthcare infrastructure, with plans to establish additional centers across the country (Alfaqeeh et al., 2017). Improving operational aspects such as extending service hours, introducing appointment systems, and enhancing patient flow management could significantly reduce ED overcrowding and improve patient satisfaction.

Provider-related factors also play a role in shaping healthcare utilization. Patient perceptions of service quality, trust, and satisfaction influence their choice between primary care and emergency services. Low satisfaction levels, stemming from poor communication, limited continuity of care, and perceived inadequacies, often drive patients to seek immediate attention at EDs. Therefore, improving patient-provider communication, ensuring consistent care, and fostering patient-centered approaches are essential components of intervention strategies.

Furthermore, the integration of mental health services within primary care settings could reduce inappropriate ED visits driven by mental health crises. Given the stigma surrounding mental health issues in Saudi society, primary care providers must be equipped to identify, manage, and refer patients appropriately. Training healthcare professionals in mental health care and reducing societal stigma can facilitate earlier intervention, decreasing the burden on EDs and specialist services.

In conclusion, tackling the issue of frequent ED utilization requires a comprehensive approach that combines infrastructural expansion, workforce development, operational improvements, and community-based interventions. Policymakers should prioritize equitable distribution of healthcare resources, leverage technology for appointment scheduling, and foster a culture of continuous quality improvement. Such strategies will enhance access to primary health care, reduce unnecessary ED visits, and ultimately improve health outcomes for the Saudi population.

References

• Abuhammad, S., & Dalky, H. (2019). Ethical implications of mental health stigma: Primary health care providers’ perspectives. Global Journal of Health Science, 11(12).
• Alfaqeeh, G., Cook, E. J., Randhawa, G., & Ali, N. (2017). Access and utilization of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia. BMC Health Services Research, 17(1), 106.
• Alghanim, S. A., & Alomar, B. A. (2015). Frequent use of emergency departments in Saudi public hospitals: implications for primary health care services. Asia Pacific Journal of Public Health, 27(2), NP2521-NP2530.
• Yaya, S., Bishwajit, G., Ekholuenetale, M., Shah, V., Kadio, B., & Udenigwe, O. (2017). The urban-rural difference in satisfaction with primary healthcare services in Ghana. BMC Health Services Research, 17(1), 776.
• Chiu, Y., Racine-Hemming’s, F., Dufour, I., Vanasse, A., Chouinard, M. C., Bisson, M., & Hudon, C. (2019). Statistical tools used for analyses of frequent users of the emergency department: a scoping review. BMJ Open, 9(5), e027750.
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