Analysis of Medical Management in Geriatric Patients in the Hospital Emergency Department by Example of Selected Cities with County Status in Poland: A Retrospective Cohort Study.

Mariusz Celiński,Mateusz Cybulski,Anna Ślifirczyk,Mariusz Goniewicz,Marta Muszalik,Joanna Fiłon,Elżbieta Krajewska-Kułak

doi:10.3390/ijerph19010048

Abstract

The aim of this study was to analyse medical management in geriatric patients in the Hospital Emergency Departments in the Biała Podlaska County and Chełm County (Poland) between 2016 and 2018 in a group of patients ≥65 years of age. We analysed medical records of 829 patients transported to Hospital Emergency Departments by Medical Emergency Teams. The research was conducted in the period from June 2019 to March 2020. We analysed emergency medical procedure forms and medical records of patients transported to the hospitals. Cardiovascular diseases were diagnosed in 40% of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the Hospital Emergency Departments in more than 2/3 of cases. The concordance between the diagnoses made by the Medical Emergency Teams and those made at the Hospital Emergency Departments was confirmed for 78% patients admitted to the department (n = 647), whereas the concordance of classification at the group level was estimated at 71.7% (n = 594). Further in-patient treatment was initiated in some of the patients admitted to the department (n = 385). The mean time of hospital stay was 10.1 days. In conclusion, differences between the initial diagnosis made by the heads of the Medical Emergency Teams and the diagnosis made by the doctor on duty in the Hospital Emergency Departments depended on the chapter of diseases in the ICD-10 classification, but they were acceptable. The majority of the patients were transported to Hospital Emergency Departments. The most common groups of diseases that require Hospital Emergency Departments admission include cardiovascular diseases, injuries due to external causes, and respiratory diseases. A moderate percentage of patients were qualified for further specialist treatment in hospital departments.

Highlights

Licensee MDPI, Basel, Switzerland.Population ageing, manifested by an inevitable increase in the share of older people in the population structure, is a progressive demographic phenomenon observed in all countries worldwide
Our goal was to analyse the procedures performed on the patient and the diagnostic process, and, the final diagnosis made by a specialist doctor, as well as to compare the previous diagnosis made by the head of the Medical Emergency Team (MET) with the one made by the doctor in the HED
The emergency medical procedure form may be electronic or paper; it is always issued in two copies, one of which is given to the patient or their legal representative, and, in the case of transporting the patient to the hospital, it is handed in to the doctor on duty in the Hospital Emergency Department on a given day

Summary

Introduction

Population ageing, manifested by an inevitable increase in the share of older people in the population structure, is a progressive demographic phenomenon observed in all countries worldwide. According to UN data, there were 727 million persons aged ≥65 years worldwide in 2020. This number is expected to more than double to 1.5 billion in 2050 [1]. It is expected that the percentage of individuals >80 years of age will increase significantly, from 137 million in 2017 to 425 million in 2050 [2]. The demographic forecast published maps and institutional affil-

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