Analysis of Medical Management in Geriatric Patients in the Hospital Emergency Department by Example of Selected Cities with County Status in Poland: A Retrospective Cohort Study

Mariusz Celiński, Mateusz Cybulski, Joanna Fiłon, Marta Muszalik, Mariusz Goniewicz, Elżbieta Krajewska-Kułak and Anna Ślifirczyk
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Mariusz Celiński: Department of Emergency Medicine, Faculty of Health Sciences, Pope John Paul II State School of Higher Education in Biała Podlaska, 21-500 Biała Podlaska, Poland
Mateusz Cybulski: Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Białystok, 15-096 Białystok, Poland
Joanna Fiłon: Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Białystok, 15-096 Białystok, Poland
Marta Muszalik: Department of Geriatrics, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus in Toruń, 85-094 Bydgoszcz, Poland
Mariusz Goniewicz: Interfaculty Centre for Didactics, Department of Emergency Medicine, Medical University of Lublin, 20-093 Lublin, Poland
Elżbieta Krajewska-Kułak: Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Białystok, 15-096 Białystok, Poland
Anna Ślifirczyk: Department of Emergency Medicine, Faculty of Health Sciences, Pope John Paul II State School of Higher Education in Biała Podlaska, 21-500 Biała Podlaska, Poland

IJERPH, 2021, vol. 19, issue 1, 1-17

Abstract: The aim of this study was to analyse medical management in geriatric patients in the Hospital Emergency Departments in the Biała Podlaska County and Chełm County (Poland) between 2016 and 2018 in a group of patients ≥65 years of age. We analysed medical records of 829 patients transported to Hospital Emergency Departments by Medical Emergency Teams. The research was conducted in the period from June 2019 to March 2020. We analysed emergency medical procedure forms and medical records of patients transported to the hospitals. Cardiovascular diseases were diagnosed in 40% of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the Hospital Emergency Departments in more than 2 / 3 of cases. The concordance between the diagnoses made by the Medical Emergency Teams and those made at the Hospital Emergency Departments was confirmed for 78% patients admitted to the department (n = 647), whereas the concordance of classification at the group level was estimated at 71.7% (n = 594). Further in-patient treatment was initiated in some of the patients admitted to the department (n = 385). The mean time of hospital stay was 10.1 days. In conclusion, differences between the initial diagnosis made by the heads of the Medical Emergency Teams and the diagnosis made by the doctor on duty in the Hospital Emergency Departments depended on the chapter of diseases in the ICD-10 classification, but they were acceptable. The majority of the patients were transported to Hospital Emergency Departments. The most common groups of diseases that require Hospital Emergency Departments admission include cardiovascular diseases, injuries due to external causes, and respiratory diseases. A moderate percentage of patients were qualified for further specialist treatment in hospital departments.

Keywords: hospital emergency departments; elderly; emergency medicine; older adults; seniors; geriatrics; cardiovascular diseases; respiratory diseases; injuries (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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