Non-urgent visits to emergency departments: a qualitative study in Iran exploring causes, consequences and solutions

OBJECTIVE: To explore the causes and consequences of non-urgent visits to emergency departments in Iran and then suggest solutions from the healthcare providers’ viewpoint. DESIGN: Qualitative descriptive study with in-depth, open-ended, and semistructured interviews, which were inductively analysed using qualitative content analysis. SETTING: A territorial, educational and military hospital in Iran. PARTICIPANTS: Eleven healthcare providers including eight nurses, two emergency medicine specialists and one emergency medicine resident. RESULTS: Three overarching themes of causes and consequences of non-urgent visits to the emergency department in addition to four suggested solutions were identified. The causes have encompassed the specialised services in emergency department, demand-side factors, and supply-side factors. The consequences have been categorised into three overarching themes including the negative consequences on patients, healthcare providers and emergency departments as well as the health system in general. The possible solutions for limiting and controlling non-urgent visits also involved regulatory plans, awareness-raising plans, reforms in payment mechanisms, and organisational arrangements. CONCLUSION: We highlighted the need for special attention to the appropriate use of emergency departments in Iran as a middle-income country. According to the complex nature of emergency departments and in order to control and prevent non-urgent visits, it can be suggested that policy-makers should design and implement a combination of the possible solutions.