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Type: Journal article
Title: Predicting admission of patients by their presentation to the emergency department
Author: Kim, S.
Li, J.
Hakendorf, P.
Teubner, D.
Ben-Tovim, D.
Thompson, C.
Citation: Emergency Medicine Australasia, 2014; 26(4):361-367
Publisher: Wiley
Issue Date: 2014
ISSN: 1742-6731
Statement of
Susan W Kim, Jordan Y Li, Paul Hakendorf, David JO Teubner, David I Ben-Tovim, and Campbell H Thompson
Abstract: OBJECTIVE: The present study aims to determine the importance of certain factors in predicting the need of hospital admission for a patient in the ED. METHODS: This is a retrospective observational cohort study between January 2010 and March 2012. The characteristics, including blood test results, of 100,123 patients who presented to the ED of a tertiary referral urban hospital, were incorporated into models using logistic regression in an attempt to predict the likelihood of patients' disposition on leaving the ED. These models were compared with triage nurses' prediction of patient disposition. RESULTS: Patient age, their initial presenting symptoms or diagnosis, Australasian Triage Scale category, mode of arrival, existence of any outside referral, triage time of day and day of the week were significant predictors of the patient's disposition (P < 0.001). The ordering of blood tests for any patient and the extent of abnormality of those tests increased the likelihood of admission. The accuracy of triage nurses' admission prediction was similar to that offered by a model that used the patients' presentation characteristics. The addition of blood tests to that model resulted in only 3% greater accuracy in prediction of patient disposition. CONCLUSIONS: Certain characteristics of patients as they present to hospital predict their admission. The accuracy of the triage nurses' prediction for disposition of patients is the same as that afforded by a model constructed from these characteristics. Blood test results improve disposition accuracy only slightly so admission decisions should not always wait for these results.
Keywords: hospital emergency service
length of stay
patient admission
routine diagnostic test
Rights: © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
DOI: 10.1111/1742-6723.12252
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