Urgent Care Needs Among Nonurgent Visits to the Emergency Department

In JAMA Internal Medicine, Renee Hsia and colleagues, including Ari Friedman, investigate whether nonurgent status determined in the emergency department effectively ruled out the possibility of serious pathologic conditions, and compared these findings with visits deemed as urgent from triage. The authors used data from the National Hospital Ambulatory Medical Care Survey to compare characteristics and outcomes of nonurgent visits with those of urgent visits. They find that a nontrivial proportion of ED visits that were deemed nonrurgent arrived by ambulance, received diagnostic services, had procedures performed, and were admitted to the hospital. Additionally, nonurgent visits shared five of the top ten diagnoses of urgent visits. These findings highlight the lack of certainty of nonurgent status even when it is determined prospectively by a provider at triage, and suggest that caution must be taken when using triage scores to rule out the possibility of severe illness in a patient considered nonurgent.