Evaluation of Patients’ Referral Causes to the Emergency Department

Abstract

Background and Objectives: Proper management of resources and patients in emergency departments (ED) is the main priority of the hospitals. By investigating patient referrals to our ED during 5 years, we tried to help making policies about development and management of ED. Methods: In this cross-sectional descriptive study, data pertaining to etiology of admission and final discharge of patients were collected through medical record review (HIS) from 2011 to 2015, and analyzed utilizing SPSS software. Results: 444552 patients were referred to our ED among whom 22.37% were outpatients. The most common indications for admission were trauma (37.97%), abdominal pain (20.63%), headache (10.59%) and CVA impression (3.59%). 25.92% of patients had personal consent to leave the ED without being visited (Left Without Being Visited: LWBV) by a physician. Mortality rate was 0.76% in five years. Trauma was the most common cause of death in first three years (25.87%, 20.90% and 20.07%, respectively); and decreasing level of consciousness was the most common cause of death in last two years (22.89% and 30.40%, respectively). Conclusion: Considering safety and patient’s satisfaction as two factors determining quality of emergency care, these findings reveal the need for reducing LWBS (by improving communication skills and quality of care) and lowering the incidence of mortality and morbidities (by improving diagnostic and therapeutic skills).