Acil Serviste Uzun Süreli Yatışlar: Acilin Uygunsuz Kullanımı mı, Yaşlılığın Sonucu mu?

Abstract

Objective: Emergency department (ED) crowding has long been recognized as a ''crisis'' in Turkey. The reasons for overcrowding are high number of patients, limited capacity of in-patient clinics, patients aged 65 years of age or older, and a prolonged length of stay in ED. This study aimed to investigate the causes of increased ED stay in a university hospital, in Turkey. Material and Methods: This was a prospective observational study carried out over 3 months. We evaluated the data of the outpatients and patients transferred by ambulance to the ED of a university hospital in Turkey. Age, gender, triage scores, date and time of presentation, discharge date and time, definitive diagnosis time, diagnosis categories, and the length of stay in ED were analyzed. Results: The mean age of 1311patients was 57.68±19.35 years.The mean diagnosis time of the patients was 459.38 minutes (7.39±0.73 hours), and the mean ED stay was 2134 minutes (35.29±3.29 hours). The rate of the patients over 65 years of age (41%) ranked the highest among three age groups. The early discharge rate of the older patients was significantly lower, and their hospitalization duration was significantly higher. At the end of initial 48 hours, 625 patients (47.6%) were discharged; only 55 patients (4,1%) could be transferred and hospitalized in the related clinics, while 545 patients (41.5%) were followed-up at the Observation and Clinical Decision Unit by emergency physicians. Conclusion: In our study, it was determined that longer than 48-hour delay in transferring the patients to the clinics, and the patients ≥ 65 years of age were the most important reasons for prolonged length of stay in the ED.