The Ratio and Predictor Factors of Inappropriate and Unnecessary Use of Emergency Department Services

Abstract

Introduction: Provision of unnecessary medical services is one of the problems that have driven up health care budgets. The condition of Emergency department and sometimes patients 'unreasonable expectations may lead to ED staff burnout and increase the provision of unnecessary services. Methods: In this study, the Hospital Urgencies Appropriateness Protocol (HUAP) was used to assess the appropriateness of services provided in the ED. The sample size of this study consisted of 445 patients who were selected among the patients admitted in Rasoul Akram and Firouzgar hospitals by stratified sampling. Chi-square and logistic regression tests were used to analyze the data. Results: The rate of inappropriate admission in the ED of the studied hospitals was measured at about 13%. Patients admitted to the Firouzgar ED showed a higher probability to inappropriate admission. Among considered factors, gender and Interval between the onset of symptoms and ED admission are affecting factor in inappropriate admission. Conclusion: The rate of in appropriate admission is somehow high in this study. Gender and Interval between the onset of symptoms and ED admission can be considered as predictors of the provision of unnecessary services. So it is significant to provide operational and evidence-based solutions regarding the issues related to the provision of unnecessary services in the ED.