Appropriateness of Admissions in the Emergency Room of a Tertiary Hospital

Cho, Hong-Jun; Lee, Sang-Il

Journal of Korean Society Quality Assurance Health Care 1995;2(1): 58.
Published online May 30, 1995.

응급실 방문 환자의 입원의 적절성에 영향을 미치는 요인

조홍준¹, 이상일²

¹울산대학교 의과대학 가정의학교실
²울산대학교 의과대학 예방의학교실

Appropriateness of Admissions in the Emergency Room of a Tertiary Hospital

Hong-Jun Cho¹, Sang-Il Lee²

¹Department of Family Medicine, College of Medicine, University of Ulsan
²Department of Preventive Medicine, College of Medicine, University of Ulsan

Abstract

Background
This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital.
Methods
Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05.
Results
The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited.
Conclusion
We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

Key words Appropriateness Evaluation Protocol(AEP);Admission;Emergency Room;