Emergency department visits for non-urgent patients in Siriraj Hospital: Cross-sectional descriptive study.
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Abstract
Purpose: This research aimed to examine emergency department visits for non-urgent patients and to study the relationship between the selected factors with the chosen medical service's next visit with the same conditions.
Design: A cross-sectional descriptive research.
Methods: A total of 800 non-urgent patients who visited the emergency department at Siriraj Hospital were recruited by purposive sampling from December 2016 to February 2017. The research instruments consisted of 1) the demographic data questionnaire, 2) the causes of emergency department visits for non-urgent patient’s questionnaire, and 3) the factors chosen medical service's next visit with the same condition questionnaire. The data were analyzed using descriptive statistics, Yate’s continuity correction test, or Fisher’s exact test.
Results: The findings revealed that the most common reasons for non-urgent patients who visited the emergency department were that the patient felt symptoms of a severe condition could not wait (45.5%), the patient was unaware of the context of emergency department service (21.7%), and the patient found it not convenient to receive services during official working hours (15.2%). When the factors associated with chosen medical service's next visit had the same conditions, it was discovered that perceptions of the registration process of specialized clinics had a positive correlation with the chosen medical service's next visit with the same conditions that were statistically significant (X2 = 6.11, p < .05).
Conclusion: This study indicated that the patients felt symptoms of a severe condition could not wait, and the patient was unaware of the context of emergency department service. These are the most common reasons for emergency department after-hours visits, including the fact that perceptions of the registration process of a specialized clinic had a correlation with the chosen medical service's next visit with the same conditions. Therefore, providing advice on service procedures or appointments at specialized clinics or increasing access channels to an after-hours clinic can help reduce the overcrowding of the emergency department.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ลิขสิทธิ์ของบทความที่ตีพิมพ์เป็นของวารสารพยาบาลศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย ทั้งฉบับตีพิมพ์เป็นรูปเล่มและเอกสารออนไลน์
References
Bardelli P, Kaplan V. Non-Urgent encounters in a Swiss medical emergency unit. SMW 2013; 143. doi:10.4414/smw.2013.13760.
Van Den Heede K, Van De Voorde C. Interventions to reduce emergency department utilization: a review of reviews. Health Policy 2016; 120(12): 1337–1349.
Mousavi SM, Sadeghifar J. Universal health coverage in Iran. Lancet Glob Health 2016; 4:e305–6. doi:10.1016/S2214-109X(16)00068-1.
Filippatos G, Evridiki K. The effect of emergency department crowding on patient outcomes. Health Sci J. 2015; 9(1):1–6.
Al-Otmy SS, Abduljabbar AZ, Al-Raddadi RM, et al Factors associated with non-urgent visits to the emergency department in a tertiary care centre, western Saudi Arabia: cross-sectional study. BMJ Open 2020; 10:e035951. doi: 10.1136/bmjopen-2019-035951.
Medical Records and Medical Statistics Service. Statistics of patients receiving services from the emergency department, Faculty of Medicine Siriraj Hospital 2019; Bangkok. (in Thai).
Lee JY, Oh SH, Peck EH, et al. The validity of the Canadian triage and acuity scale in predicting resource utilization and the need for immediate life-saving interventions in elderly emergency department patients. Scand J Trauma Resusc Emerg Med 2011; 19:68. doi:10.1186/1757-7241-19-68.
Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University. Guide to patient screening criteria. Bangkok. Faculty of Medicine Siriraj Hospital 2015. (in Thai)
Ng CJ, Liao PJ, Chang YC, Kuan JT, Chen JC, Hsu KH. Predictive factors for hospitalization of nonurgent patients in the emergency department. Medicine 2016; 95(26): e4053. doi: 10.1097/MD.0000000000004053.
McCormack LA, Jones SG, Coulter SL. Demographic factors influencing nonurgent emergency department utilization among a Medicaid population. Health Care Manag Sci 2017; 20: 395–402. doi:10.1007/s10729-016-9360-8.
Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Emergency department visits for nonurgent conditions: systematic literature review. Am J Manag Care 2013; 19(1): 47–59.
Becker J, Dell A, Jenkins L, et al. Reasons why patients with primary health care problems access a secondary hospital emergency centre. S Afr Med J 2012; 102: 800. doi:10.7196/SAMJ.6059.
Dawoud SO, Ahmad AMK, Alsharqi OZ, et al. Utilization of the emergency department and predicting factors associated with its use at the Saudi Ministry of health general hospitals. Glob J Health Sci 2016; 8: 90–106. doi:10.5539/gjhs.v8n1p90
Bahadori M, Mousavi SM, Teymourzadeh E, Ravangard R. Emergency department visits for non-urgent conditions in Iran: a cross-sectional study. BMJ Open. 2019; 9(10): e030927.
Yamane T. Statistics: An introduction analysis. 2nd ed. New York: Harper and Row Harper & Row; 1973.
Morgan SR, Chang AM, Alqatari M, Pines JM. Non-emergency department interventions to reduce ED utilization: a systematic review. Acad Emerg Med. 2013;20(10):969–985. doi.org/10.1111/acem.12219.
Sangsong S, Boonterm S, Bunyaphothi S, Namsai W, Konkayan P. Use of medical service among non-emergency patients after the government hour at Sunprasitthiprasong Hospital. Sanpasitthiprasong Medical Journal 2021; 40(1-3): 1-10. (in Thai).
Armartpundit T. Factors Influencing Utilization of emergency medical service of severity and critical illness patients in Ubonrathchathani Province. J Health Sci 2017; 26(5): 883-95. (in Thai).