The evaluation of the effect of implementing a hospitalization priority system to patients waiting for hospitalization in the emergency department

Introduction: The aim of this study was to evaluate the effects of the hospitalization priority system on the length of duration in the emergency department for patients who are presented to the emergency department and are planned to be hospitalized. In addition to hospitalization, occupancy in the emergency department, and the average length of duration in the emergency department, between the dates specified with this system the number of visits to the emergency department, the number of people who did not want to wait for examination in the emergency department and left, 112 acceptance and rejection rates, which department received the hospitalization priority system the most, and how many times this system was applied were also researched and these groups were compared with each other. Material and Method: This study, which is a single-center, retrospective descriptive study, was carried out in the 6-month period between 01.05.2018 and 30.10.2018 without the hospitalization priority system in the emergency department of Gazi University Medical Faculty and in the 6-month period between 01.05.2019 and 30.10.2019 with the hospitalization priority system, included all patients hospitalized to other services/intensive care units from the emergency department. Results: When compared to the same period in 2018, the total number of visits to emergency department increased by 12.88 %, and the total number of hospitalizations increased by 45.39 %. Between May and October 2018, the median number of ambulance rejections was 13 (9-16), while the same time in 2019, the median number of rejections was 9 (6-12). Between 2018 and 2019, there was a statistically significant difference in the number of rejections (p=0.026). From May to October 2018, the average length of duration in the emergency department for patients admitted to the hospital was 1.44 days (±0.22), and 0.99 days (±0.08) in 2019. Between the two years, there was a statistically significant difference in the average length of duration of patients in the emergency department (p=0.002). In the period of May-October 2019, the department that applied the hospitalization priority system the most was neurology (n=81), and a statistically significant difference was found between departments in terms of hospitalization priority (p<0.001). Conclusions: In our study, although, the number of visits to the emergency department increased after the hospitalization priority system in 2019, the number of hospitalizations from the emergency department to the wards also increased. Further examinations and treatments that should be applied to the patients were performed by the relevant departments instead of the emergency department. Aside from the increasing population, the hospitalization priority system can be used to prevent emergency department overgrowding due to variety of causes and to reduce the patient load in emergency department.