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<p>Background: The rise in the prevalence of musculoskeletal disorders (MSDs) places
a high burden on healthcare services, especially in the emergency departments (EDs)
of hospitals in Western and European countries. MSD-related complaints are one of
the most common complaints in such EDs where 10-40% of cases are non-urgent and could
be treated in a primary health care center (PHCC) instead. Findings on factors driving
patients to attend the ED instead of a PHCC are known to vary in different parts of
the world ranging from socio-economical factors to cultural preference; however, most
studies have been based primarily on western, industrialized countries and findings
are not generalizable to rapidly developing countries which exhibit the same phenomenon
such as Qatar. This study aims to extend prior research and examine factors driving
patients with non-urgent MSDs to attend the ED in the demographically diverse country
of Qatar. Study design: Purposive sampling was used to recruit patients with musculoskeletal
complaints age 18 years and older in the "See `N Treat" and "Male Fast Track" areas
at the ED of Hamad General Hospital (HGH). Patients with non-urgent MSDs were interviewed
about main reasons for attending the HGH ED instead of a PHCC. An applied thematic
approach was used to analyze data to determine themes and trends among patient responses.
Results: 97 patients were interviewed; 70% were men and 30% were women. 70% of patients
interviewed were non-Qatari. The median age of all patients was 35.5 years old (IQR,
27-44.2). The main reasons given for attending an ED were: seeking immediate relief
from feeling severe pain (63%), perceived severity of the condition as an emergency
and believing ED use is appropriate (29%), and referral from other health facilities
(9%). The main reasons for attending the ED of HGH particularly were: preference/convenience
(49%), access (15%), lack of knowledge (15%), and influence by employer (15%). Conclusion:
The majority of patients preferred attending the ED of HGH for the higher quality
of services in comparison to other local PHCCs. Low quality MSD management in PHCCs
for patients who experience recurrent pain is often a driving factor as well where
it was more feasible for them to access services at the ED of HGH instead of a PHCC.
A significant portion of non-Qatari patients attended the ED due to lack of knowledge
of other services and misadvise from their employers. Such external factors leading
to increased burden on the ED of HGH could be addressed by increasing access to alternative
centers. Mandating employers to inform employees of the existence of PHCCs and provide
them with health services could also reduce the burden of non-urgent ED use. Enforcement
of established protocols and strategies on MSD management could also improve the quality
of service in PHCCs and contribute to MSD prevention, thus lowering the burden on
the healthcare system.</p>
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