The impact of non-urgent visits on Emergency Department’s waiting time in Saudi Arabia general hospitals’ main regions: an observation study

Abstract Background: Emergency department (ED) overcrowding is a serious issue worldwide. It is associated with longer waiting times for patients, which can have negative consequences for patient care. Non-urgent cases that are seen in the ED can often be treated in alternative primary health settings. This study aimed to assess the relationship between non-urgent patients' Canadian Emergency Department Triage and Acuity Scale (CTAS) scores and waiting times for urgent patients. Methods: This was a cross-sectional, retrospective observational study using secondary data. Data were presented as frequencies and means. T-tests and chi-square tests were used to assess the relationship between waiting times and level of cases' urgency. Results: A total of 136,668 ED visits were included in the study from three regions. The percentage of non-urgent cases ranged from 40% to 51%, which exceeded national and international acceptable levels. There was a significant difference between mean waiting times for urgent cases and non-urgent cases for the four key performance indicators (KPIs): door-to-doctor, doctor-to-decision, decision-to-disposition, and door-to-disposition (percentage of patients seen within 4 hours). Conclusion: The availability of non-urgent cases prolonged waiting times for urgent cases. Further measures need to be adopted to reduce waiting times and assess patient and visit characteristics for non-urgent cases.