Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study
Introduction: Emergency department discharge destination is an important topic in both clinical practice and management. This study aimed to analyze the association of Care Complexity Individual Factors (CCIFs) with discharge destinations in patients who visit the emergency department (ED). Metho...
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2025-01-01
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| Series: | Archives of Academic Emergency Medicine |
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| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2517 |
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| author | Andrea Urbina Jordi Adamuz Maria-Eulàlia Juvé-Udina Judith Peñafiel-Muñoz Virginia Munoa-Urruticoechea Maribel González-Samartino Pilar Delgado-Hito Javier Jacob Marta Romero-García |
| author_facet | Andrea Urbina Jordi Adamuz Maria-Eulàlia Juvé-Udina Judith Peñafiel-Muñoz Virginia Munoa-Urruticoechea Maribel González-Samartino Pilar Delgado-Hito Javier Jacob Marta Romero-García |
| author_sort | Andrea Urbina |
| collection | DOAJ |
| description |
Introduction: Emergency department discharge destination is an important topic in both clinical practice and management. This study aimed to analyze the association of Care Complexity Individual Factors (CCIFs) with discharge destinations in patients who visit the emergency department (ED).
Methods: This is a retrospective cohort study with consecutive sampling, including all patients who visited the ED of a tertiary hospital during 2021-2022. Data were collected from electronic health records. The main study outcomes were discharge destinations (mortality, intensive care unit admission, hospitalization, left without being seen/discharge against medical advice, and home discharge) and 26 CCIFs. Independent multinomial logistic regression was used for assessing the association of each factor and the discharge destinations, adjusted for age, sex, and triage level. All analyses were performed with R, version 4.3.2.
Results: A total of 35,383 patients were included. Of these, 60.8% were home discharged, 34.1% were hospitalized, 2.6% were transferred to the intensive care unit, 2.1% were left without being seen, and 0.4% died. The presence of CCIFs was a risk factor of ED mortality (odds ratio (OR): 13.49 [95% confidence interval (CI): 4.99;36.46]), intensive care unit admission (OR:1.26 [95%CI:1.08;1.47]), and hospitalization (OR: 1.62 [95%CI:1.53;1.71]), whilst the presence of care complexity factors was a protective factor of discharge against medical advice (OR:0.64 [95%CI:0.55;0.74]).
Conclusion: The discharge destinations from the ED showed strong associations with the patient’s complexity factors. Health professionals should consider these relationships for the design of early detection strategies and as an aid in decision-making, to ensure equity and quality of care.
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| format | Article |
| id | doaj-art-179dbe586e694f3b9e522d3e2b3406f7 |
| institution | Kabale University |
| issn | 2645-4904 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj-art-179dbe586e694f3b9e522d3e2b3406f72025-02-11T20:47:56ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042025-01-0113110.22037/aaemj.v13i1.2517Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort StudyAndrea Urbina0Jordi Adamuz1Maria-Eulàlia Juvé-Udina2Judith Peñafiel-Muñoz3Virginia Munoa-Urruticoechea4Maribel González-Samartino5Pilar Delgado-Hito6Javier Jacob7Marta Romero-García8- Knowledge Management and Information Systems Department, Bellvitge University Hospital, Barcelona, Catalunya, Spain -IDIBELL, Institute of Biomedical Research. - Nursing Faculty. University of Barcelona, Barcelona, Catalunya, Spain.- Knowledge Management and Information Systems Department, Bellvitge University Hospital, Barcelona, Catalunya, Spain. - IDIBELL, Institute of Biomedical Research. -Fundamental and Clinical Nursing Department. Nursing Faculty. University of Barcelona (Barcelona). Spain. - Catalan Institute of Health, Barcelona, Catalunya, Spain - IDIBELL, Institute of Biomedical Research.- Biostatistics Unit, Bellvitge University Hospital, Barcelona, Catalunya, Spain; - IDIBELL, Institute of Biomedical Research.- Biostatistics Unit, Bellvitge University Hospital, Barcelona, Catalunya, Spain; - IDIBELL, Institute of Biomedical Research.- Knowledge Management and Information Systems Department, Bellvitge University Hospital, Barcelona, Catalunya, Spain. - IDIBELL, Institute of Biomedical Research. -Fundamental and Clinical Nursing Department. Nursing Faculty. University of Barcelona (Barcelona). Spain. - Fundamental and Clinical Nursing Department. Nursing Faculty. University of Barcelona, Barcelona, Catalunya, Spain - IDIBELL, Institute of Biomedical Research.- Emergency Department, Bellvitge University Hospital, Barcelona, Catalunya, Spain. - IDIBELL, Institute of Biomedical Research. - University of Barcelona, Barcelona, Catalunya, Spain.- Fundamental and Clinical Nursing Department. Nursing Faculty. University of Barcelona, Barcelona, Catalunya, Spain - IDIBELL, Institute of Biomedical Research. Introduction: Emergency department discharge destination is an important topic in both clinical practice and management. This study aimed to analyze the association of Care Complexity Individual Factors (CCIFs) with discharge destinations in patients who visit the emergency department (ED). Methods: This is a retrospective cohort study with consecutive sampling, including all patients who visited the ED of a tertiary hospital during 2021-2022. Data were collected from electronic health records. The main study outcomes were discharge destinations (mortality, intensive care unit admission, hospitalization, left without being seen/discharge against medical advice, and home discharge) and 26 CCIFs. Independent multinomial logistic regression was used for assessing the association of each factor and the discharge destinations, adjusted for age, sex, and triage level. All analyses were performed with R, version 4.3.2. Results: A total of 35,383 patients were included. Of these, 60.8% were home discharged, 34.1% were hospitalized, 2.6% were transferred to the intensive care unit, 2.1% were left without being seen, and 0.4% died. The presence of CCIFs was a risk factor of ED mortality (odds ratio (OR): 13.49 [95% confidence interval (CI): 4.99;36.46]), intensive care unit admission (OR:1.26 [95%CI:1.08;1.47]), and hospitalization (OR: 1.62 [95%CI:1.53;1.71]), whilst the presence of care complexity factors was a protective factor of discharge against medical advice (OR:0.64 [95%CI:0.55;0.74]). Conclusion: The discharge destinations from the ED showed strong associations with the patient’s complexity factors. Health professionals should consider these relationships for the design of early detection strategies and as an aid in decision-making, to ensure equity and quality of care. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2517Patient DischargeRisk FactorsEmergency DepartmentPatient Outcome AssessmentQuality of Health Care |
| spellingShingle | Andrea Urbina Jordi Adamuz Maria-Eulàlia Juvé-Udina Judith Peñafiel-Muñoz Virginia Munoa-Urruticoechea Maribel González-Samartino Pilar Delgado-Hito Javier Jacob Marta Romero-García Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study Archives of Academic Emergency Medicine Patient Discharge Risk Factors Emergency Department Patient Outcome Assessment Quality of Health Care |
| title | Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study |
| title_full | Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study |
| title_fullStr | Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study |
| title_full_unstemmed | Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study |
| title_short | Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study |
| title_sort | care complexity factors and discharge destination in an emergency department a retrospective cohort study |
| topic | Patient Discharge Risk Factors Emergency Department Patient Outcome Assessment Quality of Health Care |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2517 |
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