Inappropriate Emergency Department Visits: Insights on Incidence, Associated, and Predictive Factors From 5,429 Visits.

Autor:	Alghamdi AM; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Research Office, King Abdullah International Medical Research Center, Jeddah, SAU., Alqazenli MK; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Research Office, King Abdullah International Medical Research Center, Jeddah, SAU., Alzahrani MI; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Research Office, King Abdullah International Medical Research Center, Jeddah, SAU., Bin Khamis NA; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Research Office, King Abdullah International Medical Research Center, Jeddah, SAU., Al Yusuf GA; College of Medicine, Medical University of Warsaw, Warsaw, POL., Alaithan TM; College of Medicine, AlMaarefa University, Riyadh, SAU., Alshobaki HH; College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU., AlGhamdi MA; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Research Office, King Abdullah International Medical Research Center, Jeddah, SAU., Asiri MH; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Research Office, King Abdullah International Medical Research Center, Jeddah, SAU., Hanafi ST; Emergency Medicine, Ministry of National Guard Hospital, Jeddah, SAU.; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Research Office, King Abdullah International Medical Research Center, Jeddah, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 22; Vol. 16 (7), pp. e65091. Date of Electronic Publication: 2024 Jul 22 (Print Publication: 2024).
DOI:	10.7759/cureus.65091
Abstrakt:	Introduction: Inappropriate visits (IVs) and overcrowded emergency departments (EDs) can result in many complications for patients and medical staff. This study aimed to assess the incidence, associated factors, and predictive factors of IVs to ED. Methods: This retrospective cohort single-center study was conducted in the ED of King Abdulaziz Medical City, Jeddah, Saudi Arabia. All ED visits in February 2023 were included. They were considered appropriate if the patient required investigation tests, underwent a procedure, was admitted to an inpatient ward, was admitted to the short-stay unit, was referred for follow-up at a specialist outpatient clinic after discharge from the ED, or was referred to the ED of another hospital. Failure to have at least one of these factors led to the visit being considered inappropriate. Results: A total of 5,429 visits were included. The incidence rate of IVs was 1128 (20.7%). Of the visits, 1,028 (18.9%) were attended by patients aged <10 years, and 2,825 (52.0%) by female patients. The most reported complaints were pulmonological in 1,029 visits (18.9%). Patients with appropriate visits (AVs) had significantly higher median BMI scores than those with IVs (25.9 (20 - 3) vs. 23.7 (16.36 - 29), P  = <0.0001). Visits with pulmonological (447 (39.6%) vs. 582 (13.5%)) and otorhinolaryngologic (54 (4.7%) vs. 94 (2.1%)) complaints were significantly more likely to be inappropriate ( P  = <0.0001). In multiple logistic regression, being a male (OR: 1.3, CI: 1.1 - 1.5, P  = <0.0001), being non-Saudi (OR: 2.7, CI: 2.0 - 3.6, P  = <0.0001), and visiting on the weekend (OR: 1.1, CI: 1.0 - 1.3, P  = 0.0366) were significantly predictive of the visits being inappropriate. Conclusions: Our findings revealed a high incidence of IVs in the ED, with several factors predictive of IVs. Highlighting these factors can help minimize the incidence of IVs and, therefore, improve the quality of healthcare delivered to patients in need and their clinical outcomes. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Abdullah International Medical Research Center, Jeddah, Saudi Arabia issued approval NRJ23J/080/03. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Alghamdi et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu