Waited 10 Hours for … 5 Minutes: Should Low-Acuity Patients Wait or Seek Care Elsewhere in the Healthcare Network?

Aims and background: Emergency units were designed to handle life-threatening emergencies, but currently, low-acuity consultations predominate, generating high demand and prolonged waiting times for stable patients.Given this context, the aim of this study was to analyze waiting times and care durations according to Emergency Severity Index (ESI) categorization. Materials and methods:A retrospective, longitudinal study was conducted analyzing visits to the emergency department of the Regional Hospital of Antofagasta from December 1, 2023 to January 1, 2025.The variables analyzed included age, date and time of triage, care, discharge, and ESI categorization, among others.Descriptive analyses and nonparametric tests were performed using SPSS v.27 software.Results: During this period, 79,929 individuals attended the unit: 0.6% ESI-1, 18.2% ESI-2, 28.6% ESI-3, 52.1% ESI-4, and 0.6% ESI-5.Of these, 20.3% left without receiving care, leaving 63,695 consultations for analysis.The 75th percentile of time from triage to treatment room and from treatment room to discharge were, respectively, 1.97 and 655.84 minutes (ESI-1), 15.4 and 894.2 minutes (ESI-2), 213.5 and 567.8 minutes (ESI-3), 170.8 and 90.1 minutes (ESI-4), and 115.4 and 35.8 minutes (ESI-5).There were statistically significant differences in triage-to-room and room-to-discharge times across all ESI categories (Levene p < 0.001; Kruskal-Wallis p < 0.000).Finally, 61.1% were discharged home, 14.7% were hospitalized, and 0.3% died. Conclusion:The results indicate that the triage-to-room time for ESI-3 was longer than for ESI-4 and ESI-5.However, it is important to note that 25.3% of ESI-4 and 60.7% of ESI-5 patients left without being seen, and 98.9% of those who were seen did not require hospitalization.These findings suggest that such patients should have sought care in lower-complexity facilities.Therefore, it is essential to educate the population on the appropriate use of emergency services, which would help optimize healthcare resources and improve the functioning of the care network.Clinical significance: Managing this information enables the design of public health policies focused on patient education, with the goal of reducing overcrowding in emergency units and ensuring the efficient use of healthcare network resources.