Table 1.
Patient and consultation characteristics and comorbidities in potentially inappropriate and avoidable ED visits
| Overall (n=1,276) |
Potentially inappropriate (n=77) |
Appropriate (n=1,199) |
p-value | Potentially avoidable (ACSC) (n=373) |
Non-avoidable (non-ACSC) (n=903) |
p-value | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, [Med (IQR)] | 84.0 | (78-89) | 84.0 | (77-88) | 84.0 | (79-89) | 0.284 | 83.0 | (77-88) | 85.0 | (79-90) | <0.001 |
| Sex, [n (%)] | ||||||||||||
| Female | 793 | (62.1) | 50 | (64.9) | 743 | (62.0) | 229 | (61.4) | 564 | (62.5) | ||
| Male | 483 | (37.9) | 27 | (35.1) | 456 | (38.0) | 0.603 | 144 | (38.6) | 339 | (37.5) | 0.721 |
| Consultation characteristics | ||||||||||||
| Day of the week, [n (%)] | ||||||||||||
| Sunday | 171 | (13.4) | 10 | (13.0) | 161 | (13.4) | 42 | (11.3) | 129 | (14.3) | ||
| Monday | 181 | (14.2) | 10 | (13.0) | 171 | (14.3) | 62 | (16.6) | 119 | (13.2) | ||
| Tuesday | 180 | (14.1) | 13 | (16.9) | 167 | (13.9) | 51 | (13.7) | 129 | (14.3) | ||
| Wednesday | 206 | (16.1) | 10 | (13.0) | 196 | (16.3) | 56 | (15.0) | 150 | (16.6) | ||
| Thursday | 192 | (15.0) | 8 | (10.4) | 184 | (15.3) | 60 | (16.1) | 132 | (14.6) | ||
| Friday | 176 | (13.8) | 17 | (22.1) | 159 | (13.3) | 52 | (13.9) | 124 | (13.7) | ||
| Saturday | 170 | (13.3) | 9 | (11.7) | 161 | (13.4) | 0.373 | 50 | (13.4) | 120 | (13.3) | 0.558 |
| Visit time, [n (%)] | ||||||||||||
| 7:00 - 15:59 | 789 | (61.8) | 53 | (68.8) | 736 | (61.4) | 230 | (61.7) | 559 | (61.9) | ||
| 16:00 - 23:59 | 310 | (24.3) | 18 | (23.4) | 292 | (24.4) | 85 | (22.8) | 225 | (24.9) | ||
| 0:00 - 6:59 | 177 | (13.9) | 6 | (7.8) | 171 | (14.3) | 0.239 | 58 | (15.5) | 119 | (13.2) | 0.457 |
| Night visit (18:00 – 6:59), [n (%)] | 355 | (27.8) | 16 | (20.8) | 339 | (28.3) | 0.155 | 105 | (28.2) | 250 | (27.7) | 0.866 |
| Type of admission, [n (%)] | ||||||||||||
| Ambulance | 855 | (67.0) | 36 | (48.6) | 819 | (73.5) | 254 | (72.4) | 601 | (71.8) | ||
| General practitioner | 191 | (15.0) | 19 | (25.7) | 172 | (15.4) | 72 | (20.5) | 119 | (14.2) | ||
| Walk-in | 112 | (8.8) | 16 | (21.6) | 96 | (8.6) | 18 | (5.1) | 94 | (11.2) | ||
| Other | 30 | (2.4) | 3 | (4.1) | 27 | (2.4) | <0.001 | 7 | (2.0) | 23 | (2.7) | 0.001 |
| Triage, [Med (IQR)] | 2.0 | (2-3) | 3.0 | (2-3) | 2.0 | (2-3) | <0.001 | 2.0 | (2-3) | 2.0 | (2-3) | 0.739 |
| Triage, [n (%)] | ||||||||||||
| Life-threatening | 250 | (19.8) | 1 | (1.3) | 249 | (21.0) | 63 | (17.1) | 187 | (21.0) | ||
| Urgent conditions | 458 | (36.3) | 26 | (33.8) | 432 | (36.5) | 146 | (39.6) | 312 | (35.0) | ||
| Semi-urgent conditions | 532 | (42.2) | 45 | (58.4) | 487 | (41.1) | 157 | (42.5) | 375 | (42.0) | ||
| Non urgent conditions | 21 | (1.7) | 5 | (6.5) | 16 | (1.4) | <0.001 | 3 | (0.8) | 18 | (2.0) | 0.122 |
| Comorbidity | ||||||||||||
| Charlson Comorbidity Index, [Med (IQR)] | 6.0 | (5-8) | 6.0 | (4-8) | 6.0 | (5-8) | 0.041 | 7 | (5-9) | 6 | (4-8) | <0.001 |
| Congestive heart failure, [n (%)] | 150 | (11.8) | 5 | (6.5) | 145 | (12.1) | 0.139 | 76 | (20.4) | 74 | (8.2) | <0.001 |
| Past myocardial infarction, [n (%)] | 127 | (10.0) | 6 | (7.8) | 121 | (10.1) | 0.514 | 54 | (14.5) | 73 | (8.1) | 0.001 |
| Chronic kidney disease, [n (%)] | 455 | (35.7) | 22 | (28.6) | 433 | (36.1) | 0.180 | 164 | (44.0) | 291 | (32.2) | <0.001 |
| Diabetes, [n (%)] | 280 | (21.9) | 17 | (22.1) | 263 | (21.9) | 0.977 | 96 | (25.7) | 184 | (20.4) | 0.035 |
| Liver disease, [n (%)] | 81 | (6.3) | 4 | (5.2) | 77 | (6.4) | 0.669 | 34 | (9.1) | 47 | (5.2) | 0.009 |
| Chronic obstructive lung disease, [n (%)] | 135 | (10.6) | 11 | (14.3) | 124 | (10.3) | 0.275 | 58 | (15.5) | 77 | (8.5) | <0.001 |
| Dementia, [n (%)] | 410 | (32.1) | 22 | (28.6) | 388 | (32.4) | 0.490 | 141 | (37.8) | 269 | (29.8) | 0.005 |
| Cerebrovascular disease, [n (%)] | 301 | (23.6) | 10 | (13.0) | 291 | (24.3) | 0.024 | 65 | (17.4) | 236 | (26.1) | 0.001 |
| Hemi-/Paraplegia, [n (%)] | 212 | (16.6) | 6 | (7.8) | 206 | (17.2) | 0.032 | 46 | (12.3) | 166 | (18.4) | 0.008 |
| Peripheral artery occlusive disease, [n (%)] | 98 | (7.7) | 10 | (13.0) | 88 | (7.3) | 0.071 | 31 | (8.3) | 67 | (7.4) | 0.587 |
| Connective tissue disease, [n (%)] | 7 | (0.5) | 3 | (3.9) | 4 | (0.3) | <0.001 | 4 | (1.1) | 3 | (0.3) | 0.104 |
| Peptic ulcer, [n (%)] | 41 | (3.2) | 3 | (3.9) | 38 | (3.2) | 0.726 | 14 | (3.8) | 27 | (3.0) | 0.482 |
| Malignancy, [n (%)] | 267 | (20.9) | 10 | (13.0) | 257 | (21.4) | 0.077 | 87 | (23.3) | 180 | (19.9) | 0.176 |
| Outcome | ||||||||||||
| Hospitalization, [n (%)] | 878 | (68.8) | 0 | (0.0) | 878 | (73.2) | <0.001 | 311 | (83.4) | 567 | (62.8) | <0.001 |
| ICU transmission, [n (%)] | 194 | (15.2) | 0 | (0.0) | 194 | (16.2) | <0.001 | 58 | (15.5) | 136 | (15.1) | 0.825 |
| In-hospital death, [n (%)] | 83 | (6.5) | 0 | (0.0) | 83 | (6.9) | 0.017 | 25 | (6.7) | 58 | (6.4) | 0.854 |
Abbreviations: ACSC Ambulatory-care Sensitive Condition, ED Emergency Department, ICU Intermediate Care Unit, IQR Interquartile Range, LOS Length of stay; Med Median
Notes: the CCI’s max. value in this study was 15, even though the original score ranges from 0 to 33