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Background <p>The increasing utilization of emergency departments (EDs) for non-urgent health concerns poses significant challenges to healthcare systems worldwide. These low-acuity presentations (LAPs) are considered important contributors to ED overcrowding.</p> Objective <p>This study investigates the prevalence, sociodemographic distribution, and temporal patterns of LAPs in a&#xa0;rural Swiss hospital serving a&#xa0;region with below-average primary care physician density.</p> Methods <p>A&#xa0;retrospective cross-sectional analysis was conducted using systematically selected patient records (<i>n</i> = 1247) from the emergency department of Kantonsspital Uri. Classification of LAPs was based on explicit resource utilization criteria. Multivariate logistic regression was used to calculate adjusted prevalence estimates.</p> Results <p>Of all ED consultations, 56% (CI 54–59%) were classified as LAPs. A&#xa0;pronounced age gradient was observed, with LAP proportions of 80% (CI 72–87%) in the pediatric population (0–17&#xa0;years) compared to 37% (CI 30–45%) in the elderly (&gt; 80&#xa0;years). Self-referrals showed a&#xa0;significantly higher LAP prevalence (67%; CI 64–71%) than referrals from medical institutions (36–45%). Certain presenting symptoms, such as non-specific pain (71%; CI 63–79%) and dermatological complaints (63%; CI 50–75%), were associated with increased LAP proportions.</p> Conclusion <p>The high LAP prevalence indicates that emergency departments in rural regions serve a&#xa0;substantial dual role in providing both emergency and primary care services. This finding should be considered in resource planning and regional healthcare coordination. Innovative care models and improved integration between emergency and primary care could help to optimize resource utilization while maintaining high-quality patient care.</p>

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Prävalenz und Charakteristika von „low-acuity presentations“ auf der Notfallstation

  • 期刊论文

  • 发表日期：

    2026年1月28日

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  • Miro Gächter,
  • Antonia Gächter,
  • Georg Mang,
  • Marc Höglinger

摘要

Background

The increasing utilization of emergency departments (EDs) for non-urgent health concerns poses significant challenges to healthcare systems worldwide. These low-acuity presentations (LAPs) are considered important contributors to ED overcrowding.

Objective

This study investigates the prevalence, sociodemographic distribution, and temporal patterns of LAPs in a rural Swiss hospital serving a region with below-average primary care physician density.

Methods

A retrospective cross-sectional analysis was conducted using systematically selected patient records (n = 1247) from the emergency department of Kantonsspital Uri. Classification of LAPs was based on explicit resource utilization criteria. Multivariate logistic regression was used to calculate adjusted prevalence estimates.

Results

Of all ED consultations, 56% (CI 54–59%) were classified as LAPs. A pronounced age gradient was observed, with LAP proportions of 80% (CI 72–87%) in the pediatric population (0–17 years) compared to 37% (CI 30–45%) in the elderly (> 80 years). Self-referrals showed a significantly higher LAP prevalence (67%; CI 64–71%) than referrals from medical institutions (36–45%). Certain presenting symptoms, such as non-specific pain (71%; CI 63–79%) and dermatological complaints (63%; CI 50–75%), were associated with increased LAP proportions.

Conclusion

The high LAP prevalence indicates that emergency departments in rural regions serve a substantial dual role in providing both emergency and primary care services. This finding should be considered in resource planning and regional healthcare coordination. Innovative care models and improved integration between emergency and primary care could help to optimize resource utilization while maintaining high-quality patient care.