title: Utilization of emergency service of obstetrics and gynecology: a cross-sectional analysis of a training hospital.
abstract: BACKGROUND
  Overutilization and inappropriate use of emergency departments (EDs) by patients with non-urgent health problems has become a major concern worldwide. This study aims to describe the characteristics of obstetric and gynecologic patients admitted to the Department of Emergency Obstetric and Gynecology.
  
  
  METHODS
  A retrospective and cross-sectional study was designed at our Emergency Service of Obstetrics and Gynecology of Kayseri Education and Research Hospital of Medicine between January 1 and December 31, 2013. A total of 30,853 patients applying to emergency service were retrospectively analyzed from the admission charts, patient files and hospital automation system. Patients were assessed in terms of demographic features, presentation times, complaints, admission type (with own facilities, with consultation or with ambulance), diagnoses (urgent or non-ergent), discharge rates, clinical admission, rejection rate of examination, and rejection rate of hospitalization.
  
  
  RESULTS
  A total of 30,853 patients were analyzed retrospectively. The mean age of patients was 27.69 ± 8.44 years; 51% of patients were between 20 and 29 years old. The categories of patients in urgent and non-urgent were 69% and 31% respectively. Most common presentation time period was between 19:00 and 21:00. Labor pain, pain and bleeding during pregnency, routine antenatal control, pelvic pain and menstrual irregularity were the most common complaints. Labor pain with the rate of 21% was the most common cause of ED admission. All patients who presented with labor pain were hospitalized. Patients hospitalized for labor constituted 56% of all hospitalized patients. Among patients, 62% were treated on an outpatient basis and 38% were hospitalized. Of patients, 3.54% refused to hospitalization. The cases using the ambulance to admission constituted 1.07% of all ED patients. Of these patients who have used ambulance 3.65% refused to the patient examination.
  
  
  CONCLUSIONS
  To improve the obstetric and gynecologic emergency medical care in Turkey, demographic properties and other characteristics of patients should be analyzed in detail. Detailed analysis of the data contributes to the further design and perspective of the EDs.
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Military Hospital, Kayseri, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Aksoy
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Memorial Hospital, Kayseri, Turkey.
authors.forename: Ulku
authors.initials: U
authors.lastname: Aksoy
authors.affiliation: Department of Obstetrics and Gynecology, Etimesgut Military Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozturk
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Education and Research Hospital of Medicine, Kayseri, Turkey.
authors.forename: Sezin
authors.initials: S
authors.lastname: Ozyurt
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Education and Research Hospital of Medicine, Kayseri, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Acmaz
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Acibadem Hospital, Kayseri, Turkey.
authors.forename: Ozge Idem
authors.initials: OI
authors.lastname: Karadag
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Acibadem Hospital, Kayseri, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Yucel
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Acibadem Hospital, Kayseri, Turkey.
authors.forename: Turgut
authors.initials: T
authors.lastname: Aydin
keywords: Emergency; Gynecology; Obstetrics