Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes

Mazi Mohammed Alanazi; Hussam Abdulaziz Alghamdi; Mohammed Abdulelah Alduayj; Maryam Abdulrahman Alkhaldi; Shareef Hussain Alayuob; Danh Daifullah Alghamdi; Abdelaati Ali Babikir; Mohamed Osman Saleh; Hossin Ramzi Almahozi; Manal Ebraheem Althobiti

doi:10.24911/IJMDC.51-1763151183

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Review Article
Online Published: 05 Dec 2025

IJMDC. 2025; 9(11): 2977-2982

doi: 10.24911/IJMDC.51-1763151183

Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes

Mazi Mohammed Alanazi, Hussam Abdulaziz Alghamdi, Mohammed Abdulelah Alduayj, Maryam Abdulrahman Alkhaldi, Shareef Hussain Alayuob, Danh Daifullah Alghamdi, Abdelaati Ali Babikir, Mohamed Osman Saleh, Hossin Ramzi Almahozi, Manal Ebraheem Althobiti.

Abstract
Non-urgent emergency department (ED) use and primary healthcare (PHC) bypass result in crowding in Saudi Arabia EDs. This review aimed to summarize determinants and outcomes to inform management strategies. Electronic databases were searched from 2014 to 2025 for observational Saudi studies evaluating non-urgent Canadian Triage and Acuity Scale (CTAS) 4 and 5 ED visits or PHC bypass. Eligible designs were retrospective
analyses and cross-sectional surveys. A total of 6 original articles were included in this systematic review, including two chart reviews and four surveys in tertiary and regional hospitals. Non-urgent cases burden was high: CTAS 4 and 5 formed 61.4% of patients in the largest study; 78.5% of non-life-threatening attendees were triaged non-urgent. Common motives include routine investigations, medication refills, and mild upper respiratory symptoms. Determinants include convenience, appointment unavailability, limited PHC diagnostics, and low awareness of PHC services. Most visits ended with prescriptions and basic laboratory tests; radiology use was not needed in most cases, as well as admissions and specialty referrals. Non-urgent ED visits
are mainly affected by access and knowledge gaps and require high acuity interventions. Hence, ED demand can be decreased by expanding after-hours PHC capacity, offering rapid appointments, diagnostics, and implementing electronic referral.

Key words: Non-urgent emergency department use, primary healthcare bypass, CTAS, Saudi Arabia, electronic referral, urgent care.

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Pubmed Style

Alanazi MM, Alghamdi HA, Alduayj MA, Alkhaldi MA, Alayuob SH, Alghamdi DD, Babikir AA, Saleh MO, Almahozi HR, Althobiti ME. Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes. IJMDC. 2025; 9(11): 2977-2982. doi:10.24911/IJMDC.51-1763151183

Web Style

Alanazi MM, Alghamdi HA, Alduayj MA, Alkhaldi MA, Alayuob SH, Alghamdi DD, Babikir AA, Saleh MO, Almahozi HR, Althobiti ME. Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes. https://www.ijmdc.com/?mno=296722 [Access: June 22, 2026]. doi:10.24911/IJMDC.51-1763151183

AMA (American Medical Association) Style

Alanazi MM, Alghamdi HA, Alduayj MA, Alkhaldi MA, Alayuob SH, Alghamdi DD, Babikir AA, Saleh MO, Almahozi HR, Althobiti ME. Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes. IJMDC. 2025; 9(11): 2977-2982. doi:10.24911/IJMDC.51-1763151183

Vancouver/ICMJE Style

Alanazi MM, Alghamdi HA, Alduayj MA, Alkhaldi MA, Alayuob SH, Alghamdi DD, Babikir AA, Saleh MO, Almahozi HR, Althobiti ME. Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes. IJMDC. (2025), [cited June 22, 2026]; 9(11): 2977-2982. doi:10.24911/IJMDC.51-1763151183

Harvard Style

Alanazi, M. M., Alghamdi, . H. A., Alduayj, . M. A., Alkhaldi, . M. A., Alayuob, . S. H., Alghamdi, . D. D., Babikir, . A. A., Saleh, . M. O., Almahozi, . H. R. & Althobiti, . M. E. (2025) Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes. IJMDC, 9 (11), 2977-2982. doi:10.24911/IJMDC.51-1763151183

Turabian Style

Alanazi, Mazi Mohammed, Hussam Abdulaziz Alghamdi, Mohammed Abdulelah Alduayj, Maryam Abdulrahman Alkhaldi, Shareef Hussain Alayuob, Danh Daifullah Alghamdi, Abdelaati Ali Babikir, Mohamed Osman Saleh, Hossin Ramzi Almahozi, and Manal Ebraheem Althobiti. 2025. Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes. International Journal of Medicine in Developing Countries, 9 (11), 2977-2982. doi:10.24911/IJMDC.51-1763151183

Chicago Style

Alanazi, Mazi Mohammed, Hussam Abdulaziz Alghamdi, Mohammed Abdulelah Alduayj, Maryam Abdulrahman Alkhaldi, Shareef Hussain Alayuob, Danh Daifullah Alghamdi, Abdelaati Ali Babikir, Mohamed Osman Saleh, Hossin Ramzi Almahozi, and Manal Ebraheem Althobiti. "Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes." International Journal of Medicine in Developing Countries 9 (2025), 2977-2982. doi:10.24911/IJMDC.51-1763151183

MLA (The Modern Language Association) Style

Alanazi, Mazi Mohammed, Hussam Abdulaziz Alghamdi, Mohammed Abdulelah Alduayj, Maryam Abdulrahman Alkhaldi, Shareef Hussain Alayuob, Danh Daifullah Alghamdi, Abdelaati Ali Babikir, Mohamed Osman Saleh, Hossin Ramzi Almahozi, and Manal Ebraheem Althobiti. "Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes." International Journal of Medicine in Developing Countries 9.11 (2025), 2977-2982. Print. doi:10.24911/IJMDC.51-1763151183

APA (American Psychological Association) Style

Alanazi, M. M., Alghamdi, . H. A., Alduayj, . M. A., Alkhaldi, . M. A., Alayuob, . S. H., Alghamdi, . D. D., Babikir, . A. A., Saleh, . M. O., Almahozi, . H. R. & Althobiti, . M. E. (2025) Non-urgent emergency department use and primary health care bypass in Saudi Arabia: a systematic review of determinants and outcomes. International Journal of Medicine in Developing Countries, 9 (11), 2977-2982. doi:10.24911/IJMDC.51-1763151183

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