Abstract
BackgroundThe Emergency Room (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia.MethodsThis is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome.ResultsThe total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57–5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85–89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65–51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70–133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23–0.38).ConclusionsA low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.
Highlights
The Emergency Room (ER) is one of the most used areas in healthcare institutions
This study aims at assessing the characteristics of paediatric ER visits, as well as estimating the rate of admissions and its predictors in one large teaching hospital in the Eastern Province of Saudi Arabia (SA)
The highest number of visits belonged to the toddlers age group (32.0%), followed by schoolers (24.9%)
Summary
Problems with over utilisation and overcrowding have been reported worldwide. The Emergency Room (ER) remains one of the most utilised areas for paediatric patients in healthcare institutions. It continues to suffer from prolonged length of stay, overcrowding and extended waiting hours, all of which may lead to adverse events [1]. This is especially the case in Saudi Arabia (SA), where the ER may still be considered the main point of entrance to the healthcare system [2]. In SA, children were reported to comprise 32.6% of all ER visits in a tertiary hospital in the Capital city of Riyadh [3]
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