Journal of Isfahan Medical School

Journal of Isfahan Medical School

Frequency Distribution of Re-Hospitalization and Related Factors in Patients Discharged in 12 Hours from Alzahra Hospital Emergency Service, Isfahan, Iran during 2015 Spring and Summer

Document Type : Original Article (s)

Authors
Mehrdad Esmailian 1
Mohammad Talebpoor 2
Ali Mehrabi-Koushki 3
1 Assistant Professor, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
3 Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Several factors are related to emergency ward overcrowding and re-hospitalization may probably play a considerable role in this problem. Thus, the aim of this study was to determine re-hospitalization frequency and related factors in patients discharged in less than 12 hours from Alzahra hospital emergency service in Isfahan, Iran.Methods: This is an applied cross sectional study of patients who referred to Alzahra hospital emergency department in Isfahan during 2015 spring and summer. In this study, 400 hospital records were randomly selected and studied for re-hospitalization. Demographic and other information including the interval between two referrals, cause of the first and second hospitalization, kind of discharge and other needed information were collected. If the causes of primary and secondary referrals were the same and the interval between the two was also less than one week, it was regarded as incomplete treatment. Finally, the data was analyzed by SPSS software.Findings: 54 patients (13.5%) had re-hospitalization and the mean interval between the two referrals was 7.4 ± 5.8 days. In 30 of these patients (55.6%), the second referral was in less than 7 days. Re-hospitalization was different based on patients’ age and more frequent in those with less than 50 years. This was also different based on their job, education and types of discharge in the first admit.Conclusion: A considerable part of patients who referred to emergency ward had re-hospitalization which was related to primary diseases in almost 50% of them and this repeated refers leads to emergency overcrowding and increase of hospital cost. On the other hand, a part of this repeated hospitalization is due to incorrect management of patients in emergency ward which is due to factors related to patients and the hospital. Thus, patient who referred to emergency ward must be managed and diagnosed correctly and receive the required treatment on time.
Keywords
Emergency ward
Re-hospitalization
Repeated hospitalization
  1. Weiss SJ, Derlet R, Arndahl J, Ernst AA, Richards J, Fernandez-Frackelton M, et al. Estimating the degree of emergency department overcrowding in academic medical centers: results of the National ED Overcrowding Study (NEDOCS). Acad Emerg Med 2004; 11(1): 38-50.
  2. Naghavi M, Akbari ME. Epidemiology of trauma result from external causes (accidents) in Islamic Republic of Iran. Tehran, Iran: Fekrat Publications; 2002. p. 249. [In Prsian].
  3. Kobusingye OC, Hyder AA, Bishai D, Hicks ER, Mock C, Joshipura M. Emergency medical systems in low- and middle-income countries: recommendations for action. Bull World Health Organ 2005; 83(8): 561-640.
  4. (4) Golaghai F, Rafie M. Epidemiology of accidents result in hospitalization in emergency wards of Markazi province [Approved Research Project]. Arak, Iran: Deputy of Research, Arak University of Medical Sciences; 2002. p.13. [In Persian].
  5. ustralasian College for Emergency Medicine (ACEM). Guidelines on the Implementation of the ATS in Emergency Departments [Online]. [cited 2013 Nov]; Available from:
  6. https://www.acem.org.au/getattachment/d19d5ad3-e1f4-4e4f-bf83-7e09cae27d76/G24-Implementation-of-the-Australasian-Triage-Scal.aspx
  7. Karpiel M. Improving emergency department flow. Eliminating ED inefficiencies reduces patient wait times. Healthcare executive 2004; 19(1): 40-1.
  8. Zohoor AR, Pilevarzadeh M. Study of speed of offering services in emergency department at Kerman Bahonar Hospital in 2000. Razi J Med Sci 2003; 10(35): 413-9. [In Persian].
  9. Topacoglu H, Karcioglu O, Ozucelik N, Ozsarac M, Degerli V, Sarikaya S, et al. Analysis of factors affecting satisfaction in the emergency department: a survey of 1019 patients. Adv Ther 2004; 21(6): 380-8.
  10. Derlet RW, Kinser D, Ray L, Hamilton B, McKenzie J. Prospective identification and triage of nonemergency patients out of an emergency department: A 5-year study. Ann Emerg Med 1995; 25(2): 215-23.
  11. Ministry of Health and Medical Education. Implementation guideline for improving emergency departments of large hospitals in Universities and schools of medical sciences. Tehran, Iran:Ministry of Health and Medical Education, Deputy of Health; 2002. p. 117-9. [In Persian].
  12. Dale J, Green J, Reid F, Glucksman E. Primary care in the accident and emergency department: I. Prospective identification of patients. BMJ 1995; 311(7002): 423-6.
  13. Cooke MW, Wilson S, Pearson S. The effect of a separate stream for minor injuries on accident and emergency department waiting times. Emerg Med J 2002; 19(1): 28-30.
  14. Waldrop RD, Harper DE, Mandry C. Prospective assessment of triage in an urban emergency department. South Med J 1997; 90(12): 1208-12.
  15. Asplin BR. Undertriage, overtriage, or no triage? In search of the unnecessary emergency department visit. Ann Emerg Med 2001; 38(3): 282-5.
  16. Banerjea K, Carter AO. Waiting and interaction times for patients in a developing country accident and emergency department. Emerg Med J 2006; 23(4): 286-90.
  17. Ardagh MW, Wells JE, Cooper K, Lyons R, Patterson R, O'Donovan P. Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: a controlled prospective trial. N Z Med J 2002; 115(1157): U28.
  18. Liew D, Liew D, Kennedy MP. Emergency department length of stay independently predicts excess inpatient length of stay. Med J Aust 2003; 179(10): 524-6.
  19. Tazhibi M, Ghaderi Nansa L, Tirani M. Causes of readmission of patients to Al Zahra hospital, Iran. J Health Syst Res 2016; 7(1): 101-7.
Journal of Isfahan Medical School
Volume 34, Issue 371 - Serial Number 371
January and February 2016
Pages 98-105

  • Receive Date 05 November 2015
  • Accept Date 06 April 2022