Al-Surimi Khaled, Yenugadhati Nagarajkumar, Shaheen Naila, Althagafi Majed, Alsalamah Majid
College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
Int J Gen Med. 2021 Mar 17;14:909-921. doi: 10.2147/IJGM.S299531. eCollection 2021.
Emergency department overcrowding is becoming a challenge for the healthcare management system globally and locally. This study aimed to estimate the frequency of ED visits, describe the patients' profile along with visit-related characteristics, and associated factors in a tertiary care hospital.
A retrospective cohort study was conducted at a tertiary care hospital. The study included patients age 14 years and above visiting the main emergency department in year 2013. Data were extracted from electronic medical records by a qualified data extraction team. Statistical analyses were performed, including the odds ratio and 95% confidence interval for the factors associated with highly frequent (≥14 visits) ED visits using logistic regression models.
There were 150,727 visits to the emergency department within a year. The number of frequent visitors was 7696 (9.38%), with 42,226 visits (28.01% of total ED visits). Highly frequent visitors totaled 249 (0.30%), with 5173 visits (3.43% of total ED visits). The frequent visitors' average age was 42.55 (SD 20.14), and 48.99 (SD 21.33) for the highly frequent visitors' group. More than half of the emergency visitors were females. The most common complaints among the highly frequent visitors were Gastrointestinal (21.34%), followed by Respiratory (13.47%), Orthopedic (12.57%), and Cardiovascular (12.43%). Multivariate analysis indicated that age, history of diabetes, history of cardiac diseases, insurance status, and nationality were significant predicators of highly frequent visits to the hospital emergency.
Frequent and highly frequent visitors to emergency departments represent a significant proportion of adult patients presenting to ED. Their visits constitute almost one-third of total ED visits. Several factors associated with highly frequent ED visits have been identified. This study provides local empirical evidence to develop improvement policy and actions related to chronic issue of frequent and highly frequent visitation to hospital ED.
急诊科拥挤正成为全球及本地医疗管理系统面临的一项挑战。本研究旨在估算急诊科就诊频率，描述患者概况以及与就诊相关的特征，还有一家三级医院中的相关因素。
在一家三级医院开展了一项回顾性队列研究。该研究纳入了2013年前往主急诊科就诊的14岁及以上患者。由一个合格的数据提取团队从电子病历中提取数据。进行了统计分析，包括使用逻辑回归模型对与高频率（≥14次就诊）急诊科就诊相关因素的比值比及95%置信区间。
一年内急诊科就诊次数达150,727次。频繁就诊者有7696人（9.38%），就诊42,226次（占急诊科总就诊次数的28.01%）。高频率就诊者共计249人（0.30%），就诊5173次（占急诊科总就诊次数的3.43%）。频繁就诊者的平均年龄为42.55岁（标准差20.14），高频率就诊者组的平均年龄为48.99岁（标准差21.33）。超过半数的急诊科就诊者为女性。高频率就诊者中最常见的主诉是胃肠道问题（21.34%），其次是呼吸系统问题（13.47%）、骨科问题（12.57%）和心血管问题（12.43%）。多变量分析表明，年龄、糖尿病史、心脏病史、保险状况和国籍是医院急诊科高频率就诊的显著预测因素。
急诊科的频繁和高频率就诊者占前往急诊科就诊的成年患者的很大比例。他们的就诊次数几乎占急诊科总就诊次数的三分之一。已确定了一些与急诊科高频率就诊相关的因素。本研究提供了本地实证依据，以制定与医院急诊科频繁和高频率就诊这一长期问题相关的改进政策及行动。
