Public Knowledge of Emergency Department Triage and its Association with Patient Satisfaction in Macau During the COVID19 Era: A Cross-Sectional Study

Abstract

Background Emergency Department (ED) overcrowding is a global health challenge, intensified by the COVID-19 pandemic. Public understanding of ED triage is essential for optimizing service utilization and aligning patient expectations. This study aimed to assess public knowledge of the ED triage process in Macau during the pandemic and to examine its association with patient-reported wait times and overall satisfaction.

Methods A cross-sectional study was conducted from June to Oct 2021 among adult Macau residents. A proportionate quota sampling strategy aligned with Macau’s seven parishes recruited 480 participants. A validated 28-item questionnaire assessed socio demographic characteristics, knowledge and perceptions of the ED triage system, and patient satisfaction. Data was analyzed using descriptive statistics, chi-square tests, and Spearman's correlation. Statistical significance was set at p < 0.05.

Results A total of 446 valid questionnaires was analyzed (response rate: 92.9%). A significant knowledge deficit was identified, with 66.4% (n=296) of participants being unaware of the existence of an ED triage system. Knowledge of triage was significantly associated with a greater acceptance of triage procedures (χ² = 43.842, p < 0.001) and the principle of prioritization by urgency (χ² = 7.459, p = 0.028). Spearman’s correlation revealed a moderate negative relationship between triage knowledge and self-reported wait time (rs = -0.438, p < 0.001) and a strong negative correlation between reported wait time and overall satisfaction (rs = -0.557, p < 0.001).

Conclusion A pervasive lack of public knowledge regarding ED triage exists in Macau, a situation likely amplified by the complexities of healthcare navigation during the COVID-19 pandemic. This knowledge gap is significantly associated with unrealistic wait time expectations and lower patient satisfaction. Findings underscore the urgent need for targeted public health education and system-level interventions to improve emergency service utilization and patient experience in a post-pandemic world.