Original Articles Open access

Socio-demographic and health perception factors influencing non-urgent emergency department visits in the Veneto region: a cross-sectional pilot study

Authors

Published
4 June 2025
Section
Original Articles

Abstract

Emergency Department (ED) overcrowding is a significant issue in Italy, impacting resource allocation and patient care. Patients seeking ED care vary widely in terms of demographic characteristics and health perceptions, often presenting with non- urgent issues. Understanding the factors influencing ED utilization is essential for mitigating congestion. This study aims to assess personal and service-related factors influencing patients’ decisions to seek ED care, focusing on socio-demographic variables and health perceptions. A pilot study was conducted using a validated questionnaire adapted for the ED context. The survey was admini- stered to patients with non-urgent visits (white triage code) across four hospitals during a two-week period in October 2022. Statistical analysis, including chi-square and Fisher’s exact tests, identified associations between socio-demographic factors, health perceptions, and ED utilization motivations. A total of 792 que- stionnaires were analyzed. Findings revealed a “typical patient” characterized by high anxiety, perceived urgency, and overestima- tion of symptom severity. Significant associations were found bet- ween age, education level, chronic conditions, and ED utilization. Socio-demographic characteristics and health perceptions signifi- cantly influence ED visits. Improving patient education and awa- reness of alternative healthcare options may help alleviate ED overcrowding.

References

  1. 1. Morley C, Unwin M, Peterson GM, et al. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One 2018;13:e0203316.
  2. 2. Pujolar G, Oliver-Anglès A, Vargas I, Vázquez ML. Changes in access to health services during the COVID-19 pandemic: a scoping review. Int J Environ Res Public Health 2022;19:1749.
  3. 3. Chen CT, Wang TY, Shih CH, et al. Comparison of outcomes in emergency department revisiting patients before and after coronavirus disease 2019 epidemic. Eur J Emerg Med 2022;29:373-9.
  4. 4. Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA 2020;323:1545-6.
  5. 5. Barbieri G, Spinelli S, Filippi M, et al. COVID-19 pandemic management at the Emergency Department: the changing scenario at the University Hospital of Pisa. Emerg Care J 2020;16.
  6. 6. Matifary CR, Wachira B, Nyanja N, Kathomi C. Reasons for patients with non-urgent conditions attending the emergency department in Kenya: A qualitative study. Afr J Emerg Med 2021;11:113-7.
  7. 7. Johnson PJ, Ghildayal N, Ward AC, et al. Disparities in potentially avoidable emergency department (ED) care: ED visits for ambulatory care sensitive conditions. Med Care 2012;50:1020-8.
  8. 8. Ministero della Salute (Italy). Piano Nazionale per la Gestione delle Liste di Attesa 2022–2024. Rome, 2022.
  9. 9. Di Tommaso F, Falasca P, Rossi A, et al. Pronto Soccorso: verso un uso responsabile. Prospettive Sociali e Sanitarie 2008;21:4-6.
  10. 10. Bone AE, Evans CJ, Etkind SN, et al. Factors associated with older people's emergency department attendance towards the end of life: a systematic review. Eur J Public Health 2019;29:67-74.
  11. 11. Berkman ND, Chang E, Seibert J, et al. Management of high-need, high-cost patients: a “best fit” framework synthesis, realist review, and systematic review. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Oct. (Comparative Effectiveness Review, No. 246.) Appendix B, Results. Available from: https://www.ncbi.nlm.nih.gov/books/NBK575198/
  12. 12. Williams DR, Collins C. Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health. Public Health Rep 2001;116:404-16.
  13. 13. Hunt RC, DeHart KL, Allison EJ Jr, Whitley TW. Patient and physician perception of need for emergency medical care: a prospective and retrospective analysis. Am J Emerg Med 1996;14:635-9.
  14. 14. Benahmed N, Laokri S, Zhang WH, et al. Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium. Eur J Pediatr 2012;171:1829-37.
  15. 15. Harris MJ, Patel B, Bowen S. Primary care access and its relationship with emergency department utilisation: an observational, cross-sectional, ecological study. Br J Gen Pract 2011;61:e787-93.
  16. 16. Appoh L, Felix F, Pedersen PU. Barriers to access of healthcare services by the immigrant population in Scandinavia: a scoping review protocol. BMJ Open 2020;10:e032596.
  17. 17. Collection and integration of data on refugee and migrant health in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2020.
  18. 18. OECD. Primary Health Care Review: Italy 2023. OECD Publishing, 2023.
  19. 19. Parry K, Picard C, Devkota R, Tate K. Emergency Department Navigator Interventions and Outcome Measures: A Scoping Review. Int J Older People Nurs 2025;20:e70026.
  20. 20. Tyler S, Olis M, Aust N, et al. Use of artificial intelligence in triage in hospital emergency departments: a scoping review. Cureus 2024;16:e59906.

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.