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Retrospective study of the incidence of unstable and shock patients presenting to the emergency room.

Naimer SA, Prero MY, Freud T, Bartal C - Isr J Health Policy Res (2014)

Bottom Line: This rate was compared with the complementary bulk rate of patients presenting to the emergency room at the center.An absolute reduction of close to 50% across the different seasons of the examined years was found.All parameters of patient outcomes were similar in both periods of the study.

View Article: PubMed Central - PubMed

Affiliation: Elon Moreh Health Center, Clalit Health Services, Shomron, Israel ; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel ; Emergency Medicine Department, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel ; Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva, 84105 Israel.

ABSTRACT

Background: Over a period of three decades, medical personnel working in our emergency room observed that fewer severe cases presented to the emergency department. The objective of this study is to assess whether a genuine change in the presentation rates of clinically unstable non-trauma patients to the emergency room indeed exists.

Methods: We conducted a retrospective review of patients treated in the shock room. Patients' demographic data, diagnoses and outcomes were accessed. Populations of patients presenting to the shock room over a span of four seasons, in two separate periods eight years apart were compared. This rate was compared with the complementary bulk rate of patients presenting to the emergency room at the center.

Results: While absolute rates of emergency room utilization rose, the rate of unstable patients demanding urgent intensive care showed a clear decline. An absolute reduction of close to 50% across the different seasons of the examined years was found. Per patient, the proportion of those requiring artificial respiration and urgent hemodialysis remained uniform in both periods. All parameters of patient outcomes were similar in both periods of the study.

Conclusion: This unexplored aspect of emergency care demonstrates a dramatic decline in the incidence of unstable patients. While we should continue to reinforce delivery of superior care, our medical educational system should adapt itself to compensate for the diminished exposure of our trainees to emergencies. Further research in this field should explore whether the trend we observed exists in other geographical locations and whether this parameter can be utilized as a quality measure of medical systems.

No MeSH data available.


Related in: MedlinePlus

Comparison of number of patients admission to the emergency department shock room by year and season.
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Fig1: Comparison of number of patients admission to the emergency department shock room by year and season.

Mentions: In this study we examined the number of admissions to the shock room in the emergency department at the Soroka Medical Center during the four seasons of years 1999 - 2000 (period 1) and 2007-2008 (period 2). Despite the delay of this report due to technicalities, our medical staff continues to observe the reported trend albeit with recent relative stabilization. We observed that the number of medically unstable subjects presenting to the emergency department decreased by close to 50% (276 in ′99-′00 and 139 in ′07-′08). Figure 1 shows the comparison of the number of patients admitted to the emergency department shock room by year and season. In each season a statistically significant difference was found between the rates of emergency department shock room arrivals. Figure 2 shows the comparison of shock room admission rates to those of patient referrals to the general emergency department in each year and season. The proportion of shock room treated patients was significantly lower in period 2.Figure 1


Retrospective study of the incidence of unstable and shock patients presenting to the emergency room.

Naimer SA, Prero MY, Freud T, Bartal C - Isr J Health Policy Res (2014)

Comparison of number of patients admission to the emergency department shock room by year and season.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4221710&req=5

Fig1: Comparison of number of patients admission to the emergency department shock room by year and season.
Mentions: In this study we examined the number of admissions to the shock room in the emergency department at the Soroka Medical Center during the four seasons of years 1999 - 2000 (period 1) and 2007-2008 (period 2). Despite the delay of this report due to technicalities, our medical staff continues to observe the reported trend albeit with recent relative stabilization. We observed that the number of medically unstable subjects presenting to the emergency department decreased by close to 50% (276 in ′99-′00 and 139 in ′07-′08). Figure 1 shows the comparison of the number of patients admitted to the emergency department shock room by year and season. In each season a statistically significant difference was found between the rates of emergency department shock room arrivals. Figure 2 shows the comparison of shock room admission rates to those of patient referrals to the general emergency department in each year and season. The proportion of shock room treated patients was significantly lower in period 2.Figure 1

Bottom Line: This rate was compared with the complementary bulk rate of patients presenting to the emergency room at the center.An absolute reduction of close to 50% across the different seasons of the examined years was found.All parameters of patient outcomes were similar in both periods of the study.

View Article: PubMed Central - PubMed

Affiliation: Elon Moreh Health Center, Clalit Health Services, Shomron, Israel ; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel ; Emergency Medicine Department, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel ; Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva, 84105 Israel.

ABSTRACT

Background: Over a period of three decades, medical personnel working in our emergency room observed that fewer severe cases presented to the emergency department. The objective of this study is to assess whether a genuine change in the presentation rates of clinically unstable non-trauma patients to the emergency room indeed exists.

Methods: We conducted a retrospective review of patients treated in the shock room. Patients' demographic data, diagnoses and outcomes were accessed. Populations of patients presenting to the shock room over a span of four seasons, in two separate periods eight years apart were compared. This rate was compared with the complementary bulk rate of patients presenting to the emergency room at the center.

Results: While absolute rates of emergency room utilization rose, the rate of unstable patients demanding urgent intensive care showed a clear decline. An absolute reduction of close to 50% across the different seasons of the examined years was found. Per patient, the proportion of those requiring artificial respiration and urgent hemodialysis remained uniform in both periods. All parameters of patient outcomes were similar in both periods of the study.

Conclusion: This unexplored aspect of emergency care demonstrates a dramatic decline in the incidence of unstable patients. While we should continue to reinforce delivery of superior care, our medical educational system should adapt itself to compensate for the diminished exposure of our trainees to emergencies. Further research in this field should explore whether the trend we observed exists in other geographical locations and whether this parameter can be utilized as a quality measure of medical systems.

No MeSH data available.


Related in: MedlinePlus