Evaluation of Emergency Interhospital Patient Transfers from Province of Mardin to Out-of-Province Hospitals in a Year

Abstract Objective: This study aimed to assess patients who were transferred from emergency services throughout the province of Mardin to out-of-province hospitals by ambulance in a year. Material and Methods: In this study, all patients transferred from emergency services in the province of Mardin to out-of-province hospitals via ambulances by the Patient Referral Assessment Committee, founded under the Provincial Directorate of Health, between the dates of December 31, 2010 and December 31, 2011 were evaluated retrospectively. No exclusion criteria were used. Patients were grouped and analyzed according to their demographic characteristics, transport properties, and reasons for referral. Results: The total number of the patients included in the study was 1518 (55.8% males, 41±27 mean age). Of all, 621 patients (40.9%) were transferred from the center of Mardin province, and the other patients were transferred from 8 district hospitals and two private hospitals. It was found that the patients were transferred to 37 hospitals in 8 provinces, and a total of 562 patients (37%) were transferred to private hospitals. Cardiology (23.3%), pediatrics (11.5%), and obstetrics and gynecology (8.8%) departments were the first three clinics that patients were transferred to frequently, respectively. In total, 274 patients (18.1%) were transferred inappropriately. There was a statistically significant difference between patients' transfer hospitals (state hospital/private hospital) and the age of the patients (younger than 18 years/18 years or older) (p<0.001). In addition, the rate of adult patients' transfers to tertiary healthcare centers was significantly higher (p<0.001). Conclusion: In Mardin, cardiology, pediatrics and obstetrics and gynecology patients are the most common group of emergency patients transferred by 112 ambulances to out-of-province hospitals. Approximately 40% of the patients were transferred to private hospitals. Inappropriate patient transfers seem to be a major problem in this study, as in other studies conducted in Turkey. (JAEM 2014; 13: 62-6

Geriatric patient admissions to the emergency service

Objective: In this study, we aimed to analyze the demographic features of patients older than 65 years admitted to the emergency department. Material and Methods: All patients who were over 65 years old and admitted to a tertiary care emergency department were included in this retrospective study. Information, including admission dates (month, season), age, sex, admission type, diagnosis, duration of hospitalization, and outcome in the emergency department of the patients, was evaluated. The obtained data were analyzed with student t-test and chi-square test by using SPSS 17.0 software. Results: Of 238,222 patients admitted to the emergency department, 8793 (3.6%) were over 65 years old; 58% of the patients were female and 42% were male. The rate of chronic obstructive pulmonary disease (COPD) among respiratory problems in males and the rate of hypertension among cardiac problems in females were found to be significantly high. The highest admission rate was in the autumn months (32.6%). The most common reason for admission to the emergency department was cardiac problems (21.7%). This was followed by neurological problems, trauma, respiratory system problems, and urinary tract infections, respectively. The highest mortality rate was 45% in the general intensive care unit. The most frequent cause for mortality was cardiac problems. Conclusion: Cardiac problems were the most common cause of admissions to the emergency department, hospitalization, and mortality in geriatric patients. Future studies for determining the admission rate and most frequently observed illnesses of geriatric patients might be helpful in developing special care areas and special scanning tests for geriatric patients. (JAEM 2014; 13: 53-7)Objective: In this study, we aimed to analyze the demographic features of patients older than 65 years admitted to the emergency department. Material and Methods: All patients who were over 65 years old and admitted to a tertiary care emergency department were included in this retrospective study. Information, including admission dates (month, season), age, sex, admission type, diagnosis, duration of hospitalization, and outcome in the emergency department of the patients, was evaluated. The obtained data were analyzed with student t-test and chi-square test by using SPSS 17.0 software. Results: Of 238,222 patients admitted to the emergency department, 8793 (3.6%) were over 65 years old; 58% of the patients were female and 42% were male. The rate of chronic obstructive pulmonary disease (COPD) among respiratory problems in males and the rate of hypertension among cardiac problems in females were found to be significantly high. The highest admission rate was in the autumn months (32.6%). The most common reason for admission to the emergency department was cardiac problems (21.7%). This was followed by neurological problems, trauma, respiratory system problems, and urinary tract infections, respectively. The highest mortality rate was 45% in the general intensive care unit. The most frequent cause for mortality was cardiac problems. Conclusion: Cardiac problems were the most common cause of admissions to the emergency department, hospitalization, and mortality in geriatric patients. Future studies for determining the admission rate and most frequently observed illnesses of geriatric patients might be helpful in developing special care areas and special scanning tests for geriatric patients. (JAEM 2014; 13: 53-7