A&E strains under patient misuse

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Poor patient education is to blame for long waiting times, say physicians.

Non-acute patients are clogging up emergency rooms by failing to use primary care services for minor ailments.

Swelling numbers of low-acuity patients are sapping resources, senior UAE physicians have warned, generating lengthy waiting times for those genuinely in need of attention.

Dr Juma Bilal Fairouz, director of disease prevention at the Ministry of Health, said accident and emergency departments are used as a fast-track route to care by patients unable or unwilling to use primary care services.

"People use the emergency room as an entry into the health system," he told Medical Times. "The majority of the public doesn't know how to use the healthcare service."

Units are typically understaffed, he added, compounding the difficulty of accomodating higher patient numbers.

The problem has become so severe in Ras Al Khaimah that physicians have implemented a referral system to dissuade non-acute patients from unnecessary visits, said Dr Kaltoum, head of maternal and child health in the Emirate. "If patients are not an emergency case and they come to the emergency room, they will be issued with a slip telling them to go back and visit their primary healthcare clinic. They will not receive any medication or treatment."

Dr Ken Ouriel, medical director of Sheikh Khalifa Medical City, said the blame lay with the public sector, for failing to flag up the distinction between primary and emergency care.

"It's our responsibility to educate the population to say if you have a cold, you don't need to be seen in the ER," he said.

Historically, the sparse provision of primary care created an ER culture, he added. The lack of local services meant patients were forced to visit emergency rooms for minor conditions.

"If we are asking patients not to attend the ER with a cold, we need to provide an alternative service that is clean, local, and attentive to their needs," he said. "I'm not blaming it on the population. It is our fault for failing to provide a better service closer to home."

Tawam Hospital has taken the initiative, providing a fast-track service for non-emergency patients in an attempt to free up ER resources. "We send people to primary care clinics for cases of low acuity but we are seeing less and less of these people because they are learning about these clinics," said Dr Joseph Manna, chief of emergency services. "It's in their interest."

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