The analysis of the patients taken to emergency service by 112 Emergency Healthcare Services: a prospective clinic study

Abstract

Objectives. The aim of this study was to analyze the cases transferred by 112 emergency healthcare services (EHS) according to the triage criteria of Turkish Ministry of Health. Methods. All of the patients brought to adult emergency service unit of our hospital between April 01, 2015 and May 01, 2015 by 112 EHS have been involved in this study. The triage tags of the patients have been determined according to the criteria specified in T.R. Ministry of Health’s “Procedures and principles of emergency health services in inpatient healthcare facilities” dated October 16, 2009. The end of emergency service process has been classified as discharge, hospitalization in service, transfer to another healthcare center, and excitus. Results. A total of 1,101 patients have been involved in this study. The mean age was 45.6 years. The age range was 1-94 years. While 545 (49.50%) patients were female, 556 (50.49%) were male. The portion of Red area was 15.16% (n=167), that of Yellow 1 area 34.60% (n=381), that of Yellow 2 area 23.34% (n=279), and that of Green area 24.80% (n=274). The distribution of the patients by treatment results was as follows; discharge 86.46% (n=952), hospitalization in service 10.08% (n=111), hospitalization in intensive care 2.27% (n=25), transfer to another healthcare center 0.63% (n=7), excitus 0.5% (n=6). The total share of the 65 year-old or older cases was 23.88% (n=263). The distribution of the red area patients by triage was as the following; 47.30% (n=79) hospitalization in service, 10.7% (n=18) hospitalization in intensive care unit, 33.53% (n=56) discharge, 3.59% (n=6) exitus and 4.19% (n=7) transfer to another healthcare service. Conclusions. The inappropriate use of 112 EHS is very common. Majority of the patients taken into emergency service by 112 EHS does not require urgency. After the triage in the ambulance, the patients can be directly transferred to an appropriate field without creating a time and work load on emergency service. Moreover, after the triage in ambulance, the patients requiring the hospitalization may be transferred to the appropriate facility according to the available bed capacity. 

Keywords

• Emergency healthcare services,emergency department,ambulance

References

1. [1] Kidak L, Keskinoglu P, Sofuoglu T. [The evaluation of 112 emergency ambulance service uses in Izmir]. Genel Tip Derg 2009;19:113-9. [Article in Turkish]
2. [2] Ongel T, Satar S, Kozaci N, [Analysis of patients admitted to the emergency medicine department by the 112 Emergency Service]. JAEM 2013;12:150-4. [Article in Turkish]
3. [3] Morgans A, Burgess S. Judging a patient’s decision to seek emergency healthcare: clues for managing increasing patient demand. Aust Health Rev 2012;36:110-4.
4. [4] Henderson SG, Mason AJ. Ambulance Service Planning: Simulation and Data Visualisation. In Operations Research and Health Care: A Handbook of Methods and Applications, Volume 70, Kluwer Academic Publisher; 2004;77-102.
5. [5] Atilla OD, Oray D, Akin S, Acar K, Bilge A. [An Emergency Department perspective: ambulance transfers and referral consents of the patients]. Turk J Emerg Med 2010;10:175-80. [Article in Turkish]
6. [6] Zenginol M, Al B, Gen S, Deveci I, Yarbil P, Yilmaz D, et al. [3 yearly study results of 112 emergency ambulances in the city of Gaziantep]. JAEM 2011;10:27-32. [Article in Turkish]
7. [7] Yaylaci S, Cimilli Ozturk T, Celik Yilmazer S. [Retrospective evaluation of the urgency of patients admitted the emergency department by ambulance]. Acibadem Universitesi Saglik Bilimleri Dergisi 2013;4:64-7. [Article in Turkish]
8. [8] Yurteri H, Saran A, Ozgun I. [Evaluation of the patients transported with the emergency service ambulances]. Ulusal Travma Dergisi 1996;2:204-7. [Article in Turkish]

9. [9] Soysal S, Karcioglu O, Topacoglu. H. [Emergency medical, prehospital care]. Cerrahpasa J Med 2003;4:51-7. [Article in Turkish]
10. [10] Langhelle A, Lossius HM, Silfvast T, Bjornsson HM, Lippert FK, Ersson A, et al. International EMS systems: The Nordic countries. Resuscitation 2004;61:9-21.
11. [11] 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.
12. [12] Morris DL, Cross AB. Is the emergency service abused? BMJ 1980;281:121-3.
13. [13] Gardner GJ. The use and abuse of the ambulance service: some of the factors affecting the decision whether to call an emergency ambulance. Arch Emerg Med 1990;7:81-9.
14. [14] Palazzo FF, Warner OJ, Harron M, Sadana A. Misuse of the London ambulance service: how much and why? J Accid Emerg Med 1998;15:368-70.
15. [15] Brown E, Sindelar J. The emergent problem of ambulance misuse. Ann Emerg Med 1993;22:646-50.
16. [16] Nawar EW, Niska RW, Xu J. National Hospital Ambulatory Medical Care Survey: 2005 emergency department summary. Adv Data 2007;386:1-32.
17. [17] Oktay I, Kayisoglu N. [The assessment of the emergency health services in Tekirdag province]. Sted Dergisi 2005;14:35-7. [Article in Turkish]
18. [18] Karakus B, Cevik E, Dogan H. [112 emergency medical service in the Metropolis]. J Ist Faculty Med 2014;77:37-40. [Article in Turkish]
19. [19] T.C. Saglik Bakanligi Temel Saglik Hizmetleri Genel Mudurlugu. Temel Saglik Hizmetleri Genel Mudurlugu Calisma Yilligi 2006. 1. baskı, Ankara, Kuban Matbaacılık Yayıncılık, 2007; p.137-45.
20. [20] Nur N, Demir O. F, Cetinkaya S, Tirek N. [Evaluation of the 112 emergency service use by older people]. Turk J Geriatr 2008;11:7-11. [Article in Turkish]