Evaluation Of Patient Hospitalization By Emergency Physician Authorization: A Single Center-Retrospective Study

Year 2024, Volume: 11 Issue: 3, 474 - 480, 30.09.2024

İlter Ağaçkıran , Merve Ağaçkıran

https://doi.org/10.34087/cbusbed.1504964

Abstract

Background: By its very nature, the emergency department provides a 24/7 service, and it is a global goal to try to relieve the burden on emergency departments. To this end, we aimed to investigate the impact and appropriateness of the practice of giving emergency physicians authorization to hospitalize patients who require hospitalization but remain in the emergency department on patient outcomes.
Methods: This is a single center retrospective study. The study was conducted in a tertiary academic emergency department in Turkey between 01/05/2023 and 31/12/2023, with patients admitted to the wards on the initiative of the emergency physician.
Results: The number of patients admitted from the emergency department during the study period was 11927. Among these patients, the ratio of patients whose admission decision was made by the emergency physician was approximately 1% (n=119/11927). The median (IQR) age of patients admitted by initiative was 75 years (65-83) and 47.9% (n=57) were male. The most common admission diagnosis was pneumonia 16.8% (n=20), the most common department consulted was infectious diseases 47.9% (n=57), and the most common department admitted was internal medicine 23.5% (n=28). The mean length of hospital stay (LOHS) for all patients in the study was seven days. The mean length of stay for patients who transferred departments after admission was thirty days (p=0.004).
Conclusion: In order to prevent overcrowding in emergency departments, emergency physicians in our country are authorized to admit patients. This authorization is needed for about 1% of all hospitalized patients. If we look at the length of stay of patients admitted with this authorization, we can see that they are admitted for the right and appropriate purposes.

Keywords

Emergency room, crowding, initiative

Evaluation Of Patient Hospitalization By Emergency Physician Authorization: A Single Center-Retrospective Study

Abstract

Giriş ve Amaç: Acil servis doğası gereği 7/24 hizmet sunmaktadır ve acil servislerin rahatlatılmaya çalışılması global bir amaçtır. Bu amaçla yatması gereken ancak acil serviste kalmaya devam eden hastaların yatışı için acil hekimlerine verilen yatış yetkisi uygulamasının hasta sonlanımı üzerine etkisini ve uygunluğunu araştırmak amaçlandı.
Gereç ve Yöntem: Tek merkezli retrospektif bir çalışmadır. 01.05.2023-31.12.2023 tarihleri arasında Türkiye’de üçüncü basamak bir akademik acil serviste, acil servis hekimi insiyatifi kullanılarak servislere yatışı yapılan hastalarla çalışıldı.
Bulgular: Çalışma süresince acil servisten hastaneye yatan hasta sayısı 11927 olarak bulunuldu. Bu hastalar arasında yatış kararı acil tıp uzmanı tarafından insiyatif olarak belirlenen hasta sayısının yatan hastalara oranı yaklaşık olarak %1’dir (n=119/11927). İnsiyatifle yatırılan hastaların yaş medianı (IQR) 75 (65-83) olup, %47,9 ’u (n=57) erkekti. En sık yatış tanısı Pnömoni %16,8 (n=20), en sık konsültasyon yapılan bölüm enfeksiyon hastalıkları %47,9 (n=57), ve en sık yatış yapılan bölüm iç hastalıkları %23,5 (n=28) idi. Çalışmadaki tüm hastaların ortalama hastanede kalış süresi (OHKS) yedi gün idi. Yatışından sonra bölüm değiştiren hastaların OHKS otuz gün idi (p=0.004)
Sonuç: Acil servisin kalabalığını önlemek için ülkemizde acil hekiminin hasta yatırma yetkisi vardır. Tüm yatan hastaların yaklaşık %1 oranında bu yetkiye ihtiyaç duyulmaktadır. Yetki kullanılarak yatan hastaların hastane kalış sürelerinin uzunluğu göz önüne alındığında yatışların doğru ve uygun amaçlarla yapıldığı görülmektedir.

Keywords

Acil Tıp, kalabalık, insiyatif

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