How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department

Okyay, Ramazan Azim; Hakkoymaz, Hakan

doi:10.14744/ejmi.2020.47376

How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department

Hakan HAKKOYMAZ, (Kahramanmaraş Sütçü İmam Üniversitesi, Tıp Fakültesi, Acil Tıp Kliniği, Kahramanmaraş, Türkiye)

Ramazan AZİM (Kahramanmaraş Sütçü İmam Üniversitesi, Tıp Fakültesi, Halk Sağlığı Ana Bilim Dalı, Kahramanmaraş, Türkiye)

Eurasian Journal of Medical Investigation

0 0

Yıl: 2020 Cilt: 4 Sayı: 3 Sayfa Aralığı: 353 - 359 Metin Dili: İngilizce DOI: 10.14744/ejmi.2020.47376 İndeks Tarihi: 03-11-2020

How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department

Öz:

Objectives: Healthcare provided in the emergency department (ED) should be nonstop and every patient should beevaluated carefully. This makes EDs open to inappropriate admissions. The improper use of ED is frequent and leadsto negative consequences on both patients and the healthcare system. The aim of this study was to evaluate the frequency of inappropriate ED admissions in a tertiary hospital and to investigate the underlying factors associated withinappropriate ED admissions.Methods: Patients admitted to ED between November 19 and December 2 were evaluated according to the color triagecoding and the patient socio-demographic characteristics, complaints and the reason for ED admissions were assessed.Results: Of the 4847 admissions, 34.9% (n=1695) were found to be inappropriate. The factors that significantly and independently affect inappropriate ED admissions were found to be age <45 years (OR=1.629), male gender (OR=1.467), single or divorced status (OR=1.303), education level of university or higher (OR=1.312), and admission during work hours (OR=1.309).Conclusion: Inappropriate admission to the ED is quite common. The most crucial measure to be taken in this regardis to strengthen primary healthcare services.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Bibliyografik

1. Vedovetto A, Soriani N, Merlo E, Gregori D. The burden of inappropriate emergency department pediatric visits: why Italy needs an urgent reform. Health Serv Res 2014;49:1290–305.
2. McHale P, Wood S, Hughes K, Bellis MA, Demnitz U, Wyke S. Who uses emergency departments inappropriately and when - a national cross-sectional study using a monitoring data system. BMC Med 2013;11:258.
3. Lega F, Mengoni A. Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications. Health Policy 2008;88:326–38.
4. Tsai JC, Liang YW, Pearson WS. Utilization of emergency department in patients with non-urgent medical problems: patient preference and emergency department convenience. J Formos Med Assoc 2010;109:533–42.
5. Fieldston ES, Alpern ER, Nadel FM, Shea JA, Alessandrini EA. A qualitative assessment of reasons for nonurgent visits to the emergency department: parent and health professional opinions. Pediatr Emerg Care 2012;28:220–5.
6. Howard MS, Davis BA, Anderson C, Cherry D, Koller P, Shelton D. Patients' perspective on choosing the emergency department for nonurgent medical care: a qualitative study exploring one reason for overcrowding. J Emerg Nurs 2005;31:429–35.
7. Guttman N, Zimmerman DR, Nelson MS. The many faces of access: reasons for medically nonurgent emergency department visits. J Health Polit Policy Law 2003;28:1089–120.
8. Brousseau DC, Hoffmann RG, Nattinger AB, Flores G, Zhang Y, Gorelick M. Quality of primary care and subsequent pediatric emergency department utilization. Pediatrics 2007;119:1131– 8.
9. Eroglu SE, Toprak SN, Urgan O, Onur OE, Denizbasi A, Akoglu H, et al. Evaluation of non-urgent visits to a busy urban emergency department. Saudi Med J 2012;33:967–72.
10. Oktay C, Cete Y, Eray O, Pekdemir M, Gunerli A. Appropriateness of emergency department visits in a Turkish university hospital. Croat Med J 2003;44:585–91.
11. Ersel M, Karcıoğlu Ö, Yanturalı S, Yürüktümen A, Sever M, Tunç A. Bir acil servisin kullanım özellikleri ve başvuran hastaların aciliyetinin hekim ve hasta açısından değerlendirilmesi. Turk J Emerg Med 2006;6:25–35.
12. Lee A, Lau FL, Hazelett CB, Kam CW, Wong P, Wong TW, et al. Morbidity patterns of non-urgent patients attending accident and emergency departments in Hong Kong: cross-sectional study. Hong Kong Med J 2001;7:131–8.
13. van der Linden MC, Lindeboom R, van der Linden N, van den Brand CL, Lam RC, Lucas C, et al. Self-referring patients at the emergency department: appropriateness of ED use and motives for self-referral. Int J Emerg Med 2014 16;7:28.
14. Şimşek P, Gürsoy A. Acil servislerin acil sorunu: uygunsuz kullanım. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2015;18:4.
15. Carret ML, Fassa AG, Kawachi I. Demand for emergency health service: factors associated with inappropriate use. BMC Health Serv Res 2007;7:131.
16. Pereira S, Oliveira-e-Silva A, Quintas M, Almeida J, Marujo C, Pizarro M, et al. Appropriateness of emergency department visits in a Portuguese university hospital. Ann Emerg Med 2001;37:580–6.
17. Dale J, Green J, Reid F, Glucksman E. Primary care in the accident and emergency department: I. Prospective identification of patients. BMJ 1995;311:423–6.
18. Shesser R, Kirsch T, Smith J, Hirsch R. An analysis of emergency department use by patients with minor illness. Ann Emerg Med 1991;20:743–748.
19. Davis JW, Fujimoto RY, Chan H, Juarez DT. Identifying characteristics of patients with low urgency emergency department visits in a managed care setting. Manag Care 2010;19:38–44.
20. Schappert SM. The urgency of visits to hospital emergency departments: data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), 1992. Stat Bull Metrop Insur Co 1995;76:10–19.
21. Han B, Wells BL. Inappropriate emergency department visits and use of the Health Care for the Homeless Program services by Homeless adults in the northeastern United States. J Public Health Manag Pract 2003;9:530–537.
22. Afilalo J, Marinovich A, Afilalo M, Colacone A, Leger R, Unger B, et al. Nonurgent emergency department patient characteristics and barriers to primary care. Acad Emerg Med 2004; 11:1302–10.
23. Murphy AW, Leonard C, Plunkett PK, Brazier H, Conroy R, Lynam F, et al. Characteristics of attenders and their attendances at an urban accident and emergency department over a one year period. J Accid Emerg Med 1999;16:425–7

APA	Hakkoymaz H, Okyay R (2020). How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. , 353 - 359. 10.14744/ejmi.2020.47376
Chicago	Hakkoymaz Hakan,Okyay Ramazan Azim How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. (2020): 353 - 359. 10.14744/ejmi.2020.47376
MLA	Hakkoymaz Hakan,Okyay Ramazan Azim How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. , 2020, ss.353 - 359. 10.14744/ejmi.2020.47376
AMA	Hakkoymaz H,Okyay R How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. . 2020; 353 - 359. 10.14744/ejmi.2020.47376
Vancouver	Hakkoymaz H,Okyay R How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. . 2020; 353 - 359. 10.14744/ejmi.2020.47376
IEEE	Hakkoymaz H,Okyay R "How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department." , ss.353 - 359, 2020. 10.14744/ejmi.2020.47376
ISNAD	Hakkoymaz, Hakan - Okyay, Ramazan Azim. "How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department". (2020), 353-359. https://doi.org/10.14744/ejmi.2020.47376

APA	Hakkoymaz H, Okyay R (2020). How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. Eurasian Journal of Medical Investigation, 4(3), 353 - 359. 10.14744/ejmi.2020.47376
Chicago	Hakkoymaz Hakan,Okyay Ramazan Azim How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. Eurasian Journal of Medical Investigation 4, no.3 (2020): 353 - 359. 10.14744/ejmi.2020.47376
MLA	Hakkoymaz Hakan,Okyay Ramazan Azim How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. Eurasian Journal of Medical Investigation, vol.4, no.3, 2020, ss.353 - 359. 10.14744/ejmi.2020.47376
AMA	Hakkoymaz H,Okyay R How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. Eurasian Journal of Medical Investigation. 2020; 4(3): 353 - 359. 10.14744/ejmi.2020.47376
Vancouver	Hakkoymaz H,Okyay R How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department. Eurasian Journal of Medical Investigation. 2020; 4(3): 353 - 359. 10.14744/ejmi.2020.47376
IEEE	Hakkoymaz H,Okyay R "How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department." Eurasian Journal of Medical Investigation, 4, ss.353 - 359, 2020. 10.14744/ejmi.2020.47376
ISNAD	Hakkoymaz, Hakan - Okyay, Ramazan Azim. "How Appropriate are The Emergency Department Admissions? A Study From a Tertiary Hospital Emergency Department". Eurasian Journal of Medical Investigation 4/3 (2020), 353-359. https://doi.org/10.14744/ejmi.2020.47376