Analysis of factors that determine hospitalization of emergency department patients

Background. Optimization of health care financing under current standards of treatment can be achieved by determining the factors that affect the number of hospital admissions at emergency departments (ED), and their significance. Objectives. Identification of factors determining hospitalizations at emergency department. Material and methods. The study involved 150 emergency department patients in Kedzierzyn-Kozle. An original questionnaire, the Health Behaviors Inventory, and a modified version of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) were used. Results. At greatest risk of hospitalization are those patients who: take more than 4 drugs (OR 12.17, 95% CI 2.97-73.67); are being treated for chronic diseases (OR 5.37, 95% CI 2.56-11.62); are above 44.5 years of age (OR 3.14, 95% CI 1.54-6.51); are being treated at an outpatient specialist clinic (OR 3.87, 95% CI 1.85-8.32); have a BMI above 27.1 (OR 2.84, 95% CI 1.39-5.88); have at most average material status (OR 0.42, 95% CI 0.20-0.87); have symptoms of severity greater than 5 (OR 2.23, 95% CI 1.11-4.55); and have a low index of unsatisfied needs (a Camberwell index lower than 0.825: OR 0.36, 95% CI 0.17-0.72). Conclusions. Any program to prevent hospitalization should be based on the measurement of health behavior, should focus on promoting knowledge of chronic diseases and the means of preventing them, and should involve patient education on the purpose of emergency departments. It is necessary to strive for increase responsiveness of healthcare to patients' needs and to support the area of primary-care-oriented services in the field of 'small surgery'.