The Ratio and Predictor Factors of the Inappropriate and Unnecessary Use of Emergency Department Services Publisher



Kasnavieh MH¹ ; Mahmoudinejad M¹ ; Veisi M² ; Mousavi S¹ ; Tahmasebi A³ Show Affiliations
Source: Asia Pacific Journal of Health Management Published:2023

Abstract

INTRODUCTION: Provision of unnecessary medical services is one of the problems that have driven up health care budgets. The crowding of emergency departments (ED) and sometimes patients 'unreasonable expectations, may lead to ED staff burnout and increase the provision of unnecessary services. METHODS: In this study, the Hospital Urgencies Appropriateness Protocol (HUAP) was used to assess the appropriateness of services provided in the ED. The sample size of this study consisted of 445 patients who were selected among the patients admitted in Rasoul Akram and Firouzgar hospitals in Iran by stratified sampling. Chi-square and logistic regression tests were used to analyze the data. RESULTS: The rate of inappropriate admissions in the ED of the studied hospitals was measured at about 13%. Patients admitted to the Firouzgar ED showed a higher probability of inappropriate admission. Among the considered factors, gender and the interval between the onset of symptoms and ED admission are factors affecting inappropriate admission. CONCLUSION: The rate of inappropriate admission is seen as high in this study. Gender and the interval between the onset of symptoms and an ED admission can be considered as predictors of the provision of unnecessary services. Outcomes from this study are that it is significant to provide operational and evidence-based solutions regarding the issues related to the provision of identified unnecessary services in the ED. © The Author(s) 2023.