The appropriateness of patients’ visits to an emergency department. [Die toepaslikheid van pasiënt besoeke aan ‘n noodgevalle eenheid]

Abstract

Aim: The appropriateness of patient visits to an emergency unit was investigated in this study. Method: This descriptive study included 2968 patient cards from the National District Hospital, Bloemfontein emergency unit during 2003. Patient information was evaluated according to predetermined criteria to determine whether a visit was appropriate or not. Results: The patient’s ages varied between 0 to 97 years (median 29 year) and 50.8% was female. Informal residencies presented 26.4% of patient’s neighbourhoods. The most common chronic condition was hypertension (7.9%). Only 8.4% of patients already used medication for their presenting condition. Most (72.4%) patients presented after hours and 36.6% presented during weekends. The total number of injuries was 22.9% and 75.6% were examined for medical or surgical problems. The criterion with the most visits was the trauma category (21.8%). The criterion with the least patients (0.3%) was the criterion for significant bleeding. According to the results more than a third (35.4% ; 95% CI 33.7% ; 37.2%) of the patient visits can be seen as inappropriate. Conclusion: The emergency unit is used inappropriately.