Non-Emergency ER Admissions Have Different Needs

Researchers find this group has special needs for improved access, continuity of care
By Lindsey Marcellin
HealthDay Reporter

TUESDAY, June 8 (HealthDay News) -- Non-emergency patients admitted to hospitals through the emergency department (EDNEs) need specific health care services, including improved access, fast tracking, and continuity of care, according to research published in the May issue of the Journal of Emergency Nursing.

Jee-In Hwang, Ph.D., and Hyejung Chang, Ph.D., of the Kyung Hee University in Seoul, South Korea, retrospectively reviewed data on 280,104 patients from 38 hospitals to determine differences in three groups: EDNEs, emergency patients admitted through emergency departments, and inpatients admitted through outpatient departments.

The researchers found that EDNEs comprised 13.1 percent of emergency department-initiated hospital admissions. Of these patients, 42.8 percent had four or more diagnoses, with 89.4 percent receiving radiology tests and 90.3 percent receiving at least five laboratory tests. EDNEs had a higher discharge referral rate to other facilities compared with standard inpatients (odds ratio, 3.3). Mortality rates were higher for emergency patients compared to EDNEs and standard inpatients after hospital admission (odds ratio, 2.1).

"The study findings showed that EDNEs had more complex medical problems and different health care needs. EDNEs had more diseases and more laboratory or radiology diagnostic tests but underwent fewer operations or procedures. These patients therefore seemed to be reluctant to use general clinics in primary care settings and were more likely to visit emergency departments of previously visited or preferred hospitals to meet their care needs. As hospitals shorten their length of stays, many patients are discharged with severe conditions that can often be exacerbated. These patients require follow-up care services such as subacute or rehabilitation care to prevent further deterioration, restore functioning, and maximize quality of life," the authors write.

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