Objective: The purpose of this study is to explore the causes and adequacy of the long-term care institution residents who visit emergency department of the medical center.
Background: The demands of long term care are increase rapidly due to dysfunction of aging population and changing family structure. To maintain the health of residents of long-term care institution (residents), learning unnecessary emergency department visit has been the primary task. Emergency department providing urgent medical treatment and hospitalized for those unpredictable illnesses and injuries of residents. However, unnecessary visits or misuses of emergency department may result in immediate need of emergency medical patients cannot get proper care. The purpose of this study is to explore the causes and adequacy of the residents who visit emergency department of the medical center.
Methods: Utilizing the data of emergency department of a medical center in the middle Taiwan, from 1/1/2010 to 12/31/2013. Condition that included in the analysis object is being resident of long-term care institution. We analyze the data with SPSS statistics package software, our statistics methods are chi-square test and logical regression.
Results: There are 1091 residents attended to emergency department, 53.4% of them were men, over 65 year-old accounted for 84.5%, more than three times to repeat emergency department visits accounted for 31.6%, triage grade 1 and grade 2 (resuscitation and critical) together accounting for 82.9%, the most complained of respiratory problems accounted for 44.4%, accounting for 70.3% of hospitalization, emergency department deaths accounted for 2.2%, 1.4% leave the hospital in critical condition. Using logistic regression analysis showed that the risk of hospitalization for triage occurs four 5.9 times (95% CI 1.3-26.2), consciousness (GCS) GCS score 9-12 occurs rick of hospitalization is 1.6 times than score 13-15 (95% CI 1.0-2.6), and patient who with three non-trauma complaints occurs the risk of hospitalization is 4.7 times (95% CI 1.5-14.5) than who have trauma complain.
Conclusion: The study found a high rate of residents turn hospitalized after emergency treatment (including emergency death), the most common cause is respiratory problems. This study shows that resident who arrives the emergency department of medical center has ones appropriateness.
