Analysis of The Use of An Emergency Department in A Hospital in Portugal: An Observational Study

Authors

DOI:

https://doi.org/10.12707/RVI25.30.40250

Keywords:

emergency medical services, triage, medical overuse, health literacy, digital health, access to primary care

Abstract

Background: Emergency departments (EDs) face overload due to excessive use for non-urgent conditions. The Manchester Triage System (MTS) is essential for prioritizing care according to symptomseverity.

Objective: To analyze the patterns of ED use by patients at a hospital in northern Portugal.

Methodology: An observational study using data from clinical records in the “SClínico” information system, covering all ED admissions from January 1, 2019, to December 31, 2022.

Results: ED admissions decreased in 2020, but by 2022 admissions exceeded pre-pandemic levels. The most frequent reason for ED use among non-urgent patients was mild pain.

Conclusion: The high proportion of non-urgent visits reinforces the need to promote health literacy and strengthen primary healthcare services to reduce excessive ED use.

Downloads

Download data is not yet available.

References

Andika, P. J., Safaruddin, Christina, T. Y., Baso, Y. S., & Utami, S. (2025). Effectiveness of the Manchester triage system in the emergency department: A literature review. BIO Web of Conferences, 152, 01004. https://doi.org/10.1051/bioconf/202515201004

Barbosa, J., Organista, D., Rodrigues, T., Matos, A. F., Barardo, A., Escoval, A., Bárbara, C. & Rodrigues, F. (2024). Profile of emergency department overuse in hospitalized patients with pulmonary disease and its impact on mortality. Pulmonology, 30(6), 586-594. https://doi.org/10.1016/j.pulmoe.2023.01.005

Brazão, M. L., & Baptista, A. M. (2022). Queremos mesmo melhorar as urgências em Portugal? Lusíadas Scientific Journal, 3(3), 7-11. https://doi.org/10.48687/lsj.130

Coster, J. E., Turner, J. K., Bradbury, D., & Cantrell, A. (2017). Why do people choose emergency and urgent care services? A rapid review utilizing a systematic literature search and narrative synthesis. Academic Emergency Medicine, 24(9), 1137-1149. https://doi.org/10.1111/acem.13220

Dickinson, A., & Joos, S. (2021). Barriers to integration of primary care into emergency care: Experiences in Germany. International Journal of Integrated Care, 21(2), 11. https://doi.org/10.5334/ijic.5442

Dixe, M. A., Passadouro, R., Peralta, T., Ferreira, C., Lourenço, G., & Sousa, P. M. (2018). Determinantes do acesso ao serviço de urgência por utentes não urgentes. Revista de Enfermagem Referência, 4(16), 41-52. https://doi.org/10.12707/RIV17095

European Union. (2025). Complete guide to GDPR compliance. https://gdpr.eu/

Field, A. (2018). Discovering statistics using IBM SPSS statistics (5thed.). Sage edge. Grupo Português de Triagem. (2021). Sistema de Triagem de Manchester. https://www.grupoportuguestriagem.pt/grupo-portugues-triagem/protocolo-triagem-manchester/

Instituto Nacional de Estatística. (2022). Estatísticas de saúde 2020. https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_publicacoes&PUBLICACOESpub_boui=436989156&PUBLICACOESmodo=2

International Council of Nurses. (2022). Nurses: A Voice to Lead Invest in nursing and respect rights to secure global health. https://www.icn.ch/sites/default/files/2023-04/ICN_IND_Toolkit_English_FINAL.pdf

Kessel, R. V., Wong, B. L., Clemens, T., & Brand., H. (2022). Digital health literacy as a super determinant of health: More than simply the sum of its parts. Internet Interventions, 27, 100500. https://doi.org/10.1016/j.invent.2022.100500

Mackway-Jones, K., Marsden, J., & Windle, J. (2023). Emergency triage: Manchester triage group (3rd ed.). Wiley Blackwell. Organization for Economic Co-operation and Development. (2023). Health at a glance 2023: OECD indicators. https://www.oecd.org/content/dam/oecd/en/publications/reports/2023/11/health-at-a-glance-2023_e04f8239/7a7afb35-en.pdf

Pinchbeck, E. W. (2019). Convenient primary care and emergency mhospital utilisation. Journal of Health Economics, 68, 102242. https://doi.org/10.1016/j.jhealeco.2019.102242

Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer. Portaria nº 71/2024 da Saúde. (2024). Diário da República: 1.ª Série, n.º 41. https://diariodarepublica.pt/dr/detalhe/portaria/71-2024-853780170

Savioli, G., Ceresa, I. F., Gri, N., Piccini, G. B., Longhitano, Y., Zanza, C., Piccioni, A., Esposito, C., Ricevuti, G., & Bressan, M. A. (2022). Emergency department overcrowding: Understanding the factors to find corresponding solutions. Journal of Personalized Medicine, 12(2), 279. https://doi.org/10.3390/jpm12020279

Shahid, R., Shoker, M., Chu, L. M., Frehlick, R., Ward, H., & Pahwa, P. (2022). Impact of low health literacy on patients’ health outcomes: A multicenter cohort study. BMC Health Services Research, 22, 1148. https://doi.org/10.1186/s12913-022-08527-9

Silva, F. G., Costa, S., Malcata, F., Sá, J., Vasconcelos, R., Cabral, M., Guedes, R., Vilaça, I. M., Guedes, L. P., Ferreira, J., Pereira, N., Pais, J. G., Neves, J., Monteiro, J., Pires, V., Paiva, M., Guimarães, R., Ashrafian, H., Moreira, R., … Araújo, F. (2025). Addressing the overuse of hospital emergency departments in the Portuguese NHS: A new paradigm. Frontiers in Public Health, 12, 1444951. https://doi.org/10.3389/fpubh.2024.1444951

Vainieri, M., Panero, C., & Coletta, L. (2020). Waiting times in emergency departments: A resource allocation or an efficiency issue? BMC Health Services Research, 20, 549. https://doi.org/10.1186/s12913-020-05417-w

von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). Strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. BMJ, 335, 806-808. https://doi.org/10.1136/bmj.39335.541782.AD

World Health Organization. (2021). Global patient safety action plan 2021-2030: Towards eliminating avoidable harm in health care. https://iris.who.int/server/api/core/bitstreams/a28c34c0-089c-4f5d-a0b-1-5d9c35a3cd67/content

World Medical Association. (2024). WMA Declaration of Helsinki– Ethical Principles for Medical Research Involving Human Participants. https://www.wma.net/policies-post/wma-declaration-of-helsinki/

Published

2025-12-22

How to Cite

Costa, J. S. C., Baptista, L. M. G., Carneiro, A. C. M. S., Matos, C. I. M., & Boas, S. P. S. V. (2025). Analysis of The Use of An Emergency Department in A Hospital in Portugal: An Observational Study. Journal of Nursing Referência, 6(4), 1–7. https://doi.org/10.12707/RVI25.30.40250

Issue

Section

Research Articles