A descriptive study of emergencies admitted to a surgical department.
A study was undertaken to evaluate the pattern of emergency admissions and their management by the surgical firm in a medium size (700 beds) general hospital. Over a three month period, 258 patients were admitted to one surgical team that was on take every third day. All patients were entered into a protocol that was updated daily by a registrar. In four (13.3%) of the 30 days on take, patients had to be referred to a nearby hospital due to shortage of emergency beds. The accuracy of diagnosis by the Accident and Emergency (A&E) resident, surgical resident and surgical team were 75.7, 77.2 and 88.4% respectively. The mean delay before attendance by an intern after admission was 47 (SD +/- 29) mins. Forty-four (17%) of these admissions were probably unnecessary. A further 22 (8.5%) patients had to be referred to other disciplines, indicating an initial wrong diagnosis. A substantial number of investigations were unnecessarily done on an emergency basis. Ninety-three (36.0%) patients required surgery. The median duration of hospital stay was three days. The overall morbidity was 4.2% and mortality 1.2%. The study was valuable in revealing the deficiencies in the existing emergency service; leading to new proposals to achieve our ultimate aim of providing high quality patient care.
Kum
C K
CK
Department of Surgery, National University Hospital, Singapore.
Lim
S M
SM
Rauff
A
A
D000328:Adult; D002648:Child; D003365:Costs and Cost Analysis; D004630:Emergencies; D016145:Endoscopy, Digestive System / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006300:Health Services Misuse; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D010348:Patient Care Team / Q000191:economics / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000401:mortality*; D011785:Quality Assurance, Health Care / Q000191:economics / Q000639:trends*; D012846:Singapore / Q000453:epidemiology; D013503:Surgery Department, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D015996:Survival Rate