Predicting admission of patients by their presentation to the emergency department

Susan Kim, Jordan Y. Li, Paul Hakendorf, David J.O. Teubner, David I. Ben-Tovim, Campbell H. Thompson

Research output: Contribution to journalArticle

18 Citations (Scopus)

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 100123 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.

LanguageEnglish
Pages361-367
Number of pages7
JournalEMA - Emergency Medicine Australasia
Volume26
Issue number4
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Hospital emergency service
  • Length of stay
  • Patient admission
  • Routine diagnostic test
  • Triage

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Kim, S., Li, J. Y., Hakendorf, P., Teubner, D. J. O., Ben-Tovim, D. I., & Thompson, C. H. (2014). Predicting admission of patients by their presentation to the emergency department. EMA - Emergency Medicine Australasia, 26(4), 361-367. https://doi.org/10.1111/1742-6723.12252