J Korean Soc Emerg Med.  2019 Dec;30(6):473-483. 10.0000/jksem.2019.30.6.473.

The factors affecting the level of urgency in the frequent users of the emergency department

Affiliations
  • 1Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. hjlee85@gmail.com
  • 2Biomedical Research Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 3Department of Nursing, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Abstract


OBJECTIVE
study was conducted to identify patients who actually require medical treatment in the frequent users of the emergency department (ED) and evaluate the factors affecting the level of urgency by Korean Triage and Acuity Scale.
METHODS
We retrospectively reviewed the medical records of frequent users who used more than four times a year to the ED in 2015. They were triaged on every use of ED and divided into non-urgent group and urgent group based on an average triage scale of three. The characteristics were compared between both groups.
RESULTS
The total 443 patients were frequent users and they used the ED 2,944 times. The urgent group included 92 patients, and their median number of ED uses were 4 times. The urgent group was older and higher rate of male than the non-urgent group. The more patients suffered from medical diseases such as diabetes, cerebrovascular disease, ischemic heart disease, other heart disease, lung disease, and kidney disease in the urgent group. There was no difference in education, and socioeconomic status, and ratio uses with same symptoms in both groups. At the end of the study two years later, 55% of the urgent group died.
CONCLUSION
The urgent group consists of 92 patients (21%) of the frequent emergent department users. The factors affecting the level of urgency are male sex, cerebrovascular disease, other heart disease, lung disease, and kidney disease as medical history. On the other hand, the psychiatric history and other minor diseases are factors affecting reversely the level of urgency.

Keyword

Frequent user; Emergency department; Triage

MeSH Terms

Cerebrovascular Disorders
Education
Emergencies*
Emergency Service, Hospital*
Hand
Heart Diseases
Humans
Kidney Diseases
Lung Diseases
Male
Medical Records
Myocardial Ischemia
Retrospective Studies
Social Class
Triage
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