Nearly 15% of ER Visits Could Be Managed by Family Doctors: Report

Ambulances are seen at a hospital in Toronto on April 6, 2021. The Canadian Press/Frank Gunn

Nearly one in seven patients with conditions treatable in primary care rely on emergency rooms instead, due to factors such as the lack of a regular health provider, perceptions of faster service, and difficulty getting timely family doctor appointments, according to a new report.

Roughly 1.2 million visits to the emergency department in Canada each year are for primary care conditions, and more than half of them could be managed through virtual services, according to a Dec. 5 report by the Canadian Institute for Health Information. Children, people without access to family doctors or walk-in clinics, and residents of remote or rural areas are the most likely to use emergency services for non-urgent cases.

“The emergency department is not an ideal place for patients to receive primary health care, and using it for primary care may lead to system inefficiencies,” reads the report. “There, they may face long wait times, and they do not get the benefits of being able to see their own regular health care provider who specializes in family medicine.”

The most common primary care reasons for emergency room (ER) visits include antibiotic prescriptions, colds, sore throats, ear infections and prescription refills.

In general, nearly 75 percent of Canadian adults reported difficulty getting a same-day or next-day appointment with a doctor or nurse, and a similar proportion said they have difficulty accessing care after hours, according to the report. In addition, 17 percent said they don’t have a regular health care provider.

The report is based on data collected from six provinces, including Ontario, Alberta, Saskatchewan, Nova Scotia, Prince Edward Island, and Yukon between April 2023 and March 2024.

Who Is More Likely to Use ERs for Primary Care?

Children aged 2 to 9 account for more than a quarter of visits to the emergency department for primary care, suggesting that parents of young children face barriers to timely primary care access, said the report. Younger adults aged 18 to 24 have the second largest share of such visits at 16.4 percent, while the 10-to-17 age group and the 25-to-44 age group are almost tied at just more than 15.5 percent.

Patients aged 65 years and over, on the other hand, are the least likely to visit the emergency department for primary care, probably due to their tendency to have a regular health care provider, according to the report.

Of the patients visiting emergency rooms for primary care conditions, 16.5 percent said they don’t have access to primary care, while 13.1 percent said they do. The latter figure suggests that even patients with access to a family doctor or nearby walk-in clinics “may have unmet needs for care in the community,” said the authors.

The remaining percentage corresponds to patients in provinces where emergency department registration does not include a question about access to primary care.

In terms of place of residence, almost 25 percent of primary care ER visits were made by patients living in rural or remote areas, while among patients living in urban areas, the percentage was less than 12 percent, according to the data available. The authors note this may be due to primary care infrastructure, as in rural or remote areas, the emergency department may be the only place to access care or see a family doctor.

The authors add that while addressing primary care issues may help reduce ER visits, it will not improve emergency department crowding.

“The situation in emergency departments reflects several issues in the health care system as a whole,” said the report. “ED crowding has led to longer wait times, higher proportions of patients leaving without receiving care and increased demands on staff.”