Trends in Emergency Department utilization by disease categories in a migrant-dense high-income setting: a...

Global health systems are increasingly challenged by shifting patterns of communicable diseases, non-communicable diseases, and injuries. While these patterns have been widely studied in low- and middle-income settings, there is limited evidence describing how they manifest in emergency department utilization within high-income, migrant-dense contexts such as Dubai. This study aimed to examine temporal trends in emergency department utilization by disease categories and their demographic and clinical correlations in Dubai, UAE, from 2021 to 2025.

A retrospective observational study was conducted using electronic health records of 15,679 ED visits from January 2021 to June 2025 at the Emergency Department. Diagnoses were classified into communicable diseases, non-communicable diseases, injuries, and ill-defined conditions according to WHO ICD-10-CM guidelines. Descriptive statistics were used to summarize patient characteristics and disease burden. Temporal trends were assessed across study years. Multivariable Poisson regression models were applied to examine associations between demographic and clinical factors and emergency department utilization, with results reported as incidence rate ratios and 95% confidence intervals. A p-value ≤ 0.05 was considered statistically significant.

NCDs increased by 44% (n = 1416), which included cardiovascular, digestive, and respiratory diseases. CDs have increased by 13% (n = 297), with respiratory infections being the most common, which peaked in 2023. Injuries increased by 66% (n = 324), especially among males and the younger age group. Ill-defined diseases declined by 26% (n=-1064), although they remained common in the older population. Compared to burden of disease in people aged 0 to 19 years, people aged 20-39 and 40-59 showed a higher relative risk of 8% and 9% [aRR: 1.08; 95%, CI: 1.08-1.09; aRR: 1.09, 95% CI: 1.08-1.09], while people aged 60-79 and over 80 reported a 12% and 16% higher likelihood, respectively [aRR: 1.12; 95%, CI: 1.11-1.14; aRR: 1.16, 95% CI: 1.13-1.19].

These findings highlight the need for integrated strategies linking emergency, primary, and preventive care, alongside policy measures focused on migrant health, occupational safety, and NCD prevention.