Naing@Sadiq, Lin@Mohd Ayub
(2003)
Appropriateness in utilization of emergency department services in Hospital Kota Bharu and Hospital
Universiti Sains Malaysia.
Appropriateness in utilization of emergency department services in Hospital Kota Bharu and Hospital Universiti Sains Malaysia.
(Submitted)
Abstract
The prime concern in the inappropriate utilization of emergency departments
antara J00-200 perkataan di (ED) is compromised management of patients requiring emergency treatment.
dalam Bahasa Malaysia dan Significant attendance of non-emergency cases in ED was found in several
Bahasa lnggeris. lni countries.
kemudiannya akan dimuatkan
ke dalam Laporan Talmnan
Sahagian Penyelidikan &
Pembangunan sebagai safll
cara 11ntuk menyampaikan
dapatan projek tuanl puan
kepada pihak Universiti).
The objectives of this study are to determine the proportion of inappropriate
cases, as well as the distribution of utilization by time (over 24 hours and within
a week) and by diagnoses (Phase I) and to determine the associated factors
and the reported reasons in the inappropriate utilization of ED services (Phase
II).
A cross sectional study (Phase I) was conducted in ED, Hospital Kota Bharu
(HKB) and ED, Hospital Universiti Sains Malaysia (HUSM). A sample of 350
cases from each ED was randomly selected from ED register of the year 2000.
A decision flowchart, which was adopted from 4 guidelines, was applied to
identify inappropriate cases.
The proportions of inappropriate cases were 57.4 % for ED HKB and 55 % for
ED HUSM. The inappropriate cases increased considerably in early morning,
late evening, during the weekend and early part of the week. Most common
diagnoses of inappropriate cases were upper respiratory tract infections, mild
acute gastroenteritis and urinary tract infections.
The subsequent case-control study (Phase II) with 170 cases in each group
revealed the independently significant factors associated with inappropriate
utilization of ED services such as perceived il lness (Odds Ratio (OR)=9.13;
95% Confidence Interval (CI): 4.99, 16.67), knowledge on roles and functions ofED (OR=0.65; 95% Cl : 0.50, 0.85}, knowledge on roles and functions of OPD
(OR=0.24; 95% Cl: 0.13, 0.44), marital status (OR=4.58; 95% Cl : 1.16, 18.06),
gender (OR= 3.00; 95% Cl: 1.73, 5.18), number of family members (OR=0.88;
95% Cl: 0.79, 0.97), and shift-work (OR= 2.34; 95% Cl: 1.15, 4.71).
The first 3 factors seem to be modifiable by giving education, whereas the later
4 factors give some understanding on customer needs, which may help to
customize ED and OPD services. Studies to explore further on customer needs
and customizing the hospital services accordingly, which will lead to a more
efficient primary care, are recommended.
Actions (login required)
 |
View Item |
