Factors associated with patients bypassing primary healthcare centres in Qassim Region, KSA

This study investigates the reasons for bypassing local primary healthcare centres (PHCs) by patients with minor illnesses in Qassim Region, KSA.

A cross-sectional study was performed on 266 patients that visited emergency departments in public hospitals in Qassim Region. The patients were randomly selected and categorised as level five patients (LFPs) using the Canadian Triage and Acuity Scale (CTAS) for patient characterisation.

Of the 266 patients, 85.7% had previous experience of visiting PHC facilities. The majority of these patients were not satisfied with their treatment in PHCs. Approximately 52.9% of the patients reported that the working hours at PHCs were not sufficient, 38.1% mentioned a lack of experienced staff, and 31.7% believed that PHCs were insufficient for diagnostic tests. Another 13.8% of the patients reported the unavailability of prescribed medicines. Interestingly, 17.7% of the patients reported that they never bypassed PHCs. In general, the data demonstrate that patients' gender, employment, and marital status have no significant role in their decision to skip PHCs in favor of emergency departments of public hospitals (p > 0.05).

Patients bypassing PHCs without a referral form is a serious concern that have a deleterious effect on the healthcare system, particularly emergency departments. If bypassing continues, it will increase the burden on emergency departments, particularly on healthcare services for the general population.