Users of hospital emergency department who are discharged home

• Main Author: Oddný Sigurborg Gunnarsdóttir 1955-
• Other Authors: Háskóli Íslands
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: 2012
• Subjects: Doktorsritgerðir; Lýðheilsuvísindi; Iceland
• Online Access: http://hdl.handle.net/1946/10911

The overall aim of the studies was to determine characteristics and prognosis of Emergency Department users, who were discharged home. The specific aims were to record the annual number of discharged users of the ED according to age and gender, their annual number of visits and to assess whether a higher frequency of visits predicted higher mortality; to describe the pattern of discharged diagnoses; to evaluate the association of non-causative diagnoses with mortality in general, and in particular with external causes of death, drug intoxication and suicide; to evaluate risk factors for suicide and fatal drug poisoning; to evaluate the association between death within eight days after discharge home from the ED and non-causative discharge diagnoses. Material and Methods: The data were records of patients, 18 years and older, who attended the Landspitali ED during the years 1995 to 2001. The main diagnoses were registered according to the International Classification of Diseases (ICD). Annual increase in visits was evaluated in relation to the annual population of Reykjavik capital area using the Poisson regression model and 95% Confidence Interval (CI). The pattern of each diagnosis category during the period was analyzed by calculating chi-squares for the linear trend (Mantel extension). Patients’ vital status was obtained by record linking to Statistics Iceland. The mortality of ED users was compared with the mortality of the general population of Iceland using conventional methods of calculating the standard mortality ratio (SMR) and 95% CI. The Hazard ratios (HR) and 95% CI were calculated for all causes and selected causes of death in a time-dependent analysis in which annual visits to the ED were taken into account. Furthermore, the same method was used when comparing groups with different diagnoses at discharge. In the case control studies the discharged diagnoses of mental disorders, use of alcohol, drug intoxication, non-causative diagnoses and factors influencing health status were risk factors for ...