Wahab, Nora
(2018)
A study on inappropriate attendance to Emergency Department Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
This study aimed to determine the prevalence of inappropriate attendance to Emergency
Department in Hospital Universiti Sains Malaysia (USM) within November 2016 to January
2017, demographic data, percentage of attendance for 24 hours and days in a week,
percentage of common diagnosis for inappropriate visit. This study also aimed to identify the
associated factors of inappropriate attendance to Emergency Department Hospital Universiti
Sains Malaysia
Methodology
This cross sectional study was performed in the emergency department of Hospital Universiti
Sains Malaysia, Kubang Kerian, and Kelantan. By using systematic random sampling, a
sample of 346 cases was selected. The appropriateness of the attendance then further
evaluated base on validated decision flow chart. The association between socio-demographic
and inappropriate visit to Emergency department was analysed.
Result
The total sample reviewed for this study was 346 cases. Men and women were equally
represented.95% was Malay and the rest is non-Malay (5%).
Of the total number of visit to the A&E, 22.8% (95%CI 0.18 to 0.27) were evaluated as
inappropriate and remaining as appropriate. The 24 hours utilization pattern showed the
highest peak of utilization of A&E was at 2200-2359 hour ( 95 cases) and the highest peak
for inappropriate use also was at 2200-2359 hour (25 cases).The highest rate for
inappropriate attendance to Emergency Department was on Friday ( 25.3%) .
Type of illness contributed for inappropriate visit were Upper Respiratory Tract Infection
(40%) ,mild acute gastroenteritis (3.5%),musculoskeletal pain (1.6%),soft tissue injury (2%)
urinary tract infection (0.6%),scabies (0.6%),eczema (0.3%),varicella zoster
(0,3%),conjunctivitis (0.3%),request medication (0.3%), simple abscess (0.3%), and
constipation colic(0.3%).
Factors associated with inappropriate visits were group of >45 years old (p <0.05), race
(p=0.949), gender (p=0.749) and type of illness (p=0.997).
Conclusion
Inappropriate attendance to emergency department HUSM is still significant .Although
certain group of user was recognised as contributor for inappropriate attendance, others
factors still have to recognise and evaluate so that proper steps and policies can be taken for
a better health services. .
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