Inappropriate use of emergency services: a study in a provincial hospital in Morocco

Summary Aim: The inappropriate use of emergency department decrease the quality of services allowed in this service. The main objective of this study was to determine the determinant of inappropriate use of the emergency department. Methods: The study was conducted in emergency department of the Nador Provincial Hospital, over a period of three weeks. The information gathering was done through a questionnaire. The definition of adequate consultation or not was based on the urgency or not, the day and time of consultation (day/night) and the length of symptoms. Results: Four hundred ten patients were recruited. The proportion of inappropriate consultants was 30.7%. The inappropriate consultants had social security coverage in 9.9% vs 18.3% for appropriate consultants (p = 0.02), the proportion of patients “worried to agitated” was greater among inappropriate consultants (62.3% vs 31.7%)(p < 10–6), the majority (88.9%) of inappropriate consultants felt their condition medium to very urgent vs. 45.2% in others (p < 10–6), the time to onset of symptoms was shorter in appropriate consultants (within less than 24 hours was observed in 71% of appropriate consultants vs. 6.3% in others) (p < 10–6), the proportion of consultants for traumatic lesions was significantly greater among appropriate consultants than other (59.2% vs 0.8%)(p < 10–6). Conclusion: This study identified several predictors of inappropriate consultation in the emergency department. Communication activities and public education are to be undertaken to promote the proper use of the emergency department. Further studies are necessary to take into account regional and hospital specificity. Prat Organ Soins. 2012;43(3):197-204