Care complexity factors and discharge destination in an emergency department: A retrospective cohort study

Introduction: Emergency department discharge destination is an important topic in both clinical practice and management.This study aimed to analyze the association of Care Complexity Individual Factors (CCIFs) with discharge destinations in patients who visit the emergency department (ED). Methods:...

Descripción completa

Detalles Bibliográficos
Autores: Urbina, Andrea, Adamuz, Jordi, Juvé Udina, Eulàlia, Peñafiel, Judith, Munoa-Urruticoechea, Virginia, González Samartino, Maribel, Delgado-Hito, Pilar, Jacob, Javier, Romero García, Marta
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/225488
Acceso en línea:https://hdl.handle.net/2445/225488
Access Level:acceso abierto
Palabra clave:Serveis d'urgències hospitalàries
Personal sanitari
Ingressos i altes en els hospitals
Satisfacció dels pacients
Hospital emergency services
Medical personnel
Hospital admission and discharge
Patient satisfaction
id ES_fd9045cab3a087f33da44ff1555e1fdb
oai_identifier_str oai:recercat.cat:2445/225488
network_acronym_str ES
network_name_str España
repository_id_str
spelling Care complexity factors and discharge destination in an emergency department: A retrospective cohort studyUrbina, AndreaAdamuz, JordiJuvé Udina, EulàliaPeñafiel, JudithMunoa-Urruticoechea, VirginiaGonzález Samartino, MaribelDelgado-Hito, PilarJacob, JavierRomero García, MartaServeis d'urgències hospitalàriesPersonal sanitariIngressos i altes en els hospitalsSatisfacció dels pacientsHospital emergency servicesMedical personnelHospital admission and dischargePatient satisfactionIntroduction: Emergency department discharge destination is an important topic in both clinical practice and management.This study aimed to analyze the association of Care Complexity Individual Factors (CCIFs) with discharge destinations in patients who visit the emergency department (ED). Methods: This is a retrospective cohort study with consecutive sampling, including all patients who visited the ED of a tertiary hospital during 2021-2022. Data were collected from electronic health records. The main study outcomes were discharge destinations (mortality, intensive care unit admission, hospitalization, left without being seen/discharge against medical advice, and home discharge) and 26 CCIFs. Independent multinomial logistic regression was used for assessing the association of each factor and the discharge destinations, adjusted for age, sex, and triage level. All analyses were performed with R, version 4.3.2. Results: A total of 35,383 patients were included. Of these, 60.8% were home discharged, 34.1% were hospitalized, 2.6% were transferred to the intensive care unit, 2.1% were left without being seen, and 0.4% died. The presence of CCIFs was a risk factor of ED mortality (odds ratio (OR): 13.49 [95% confidence interval (CI): 4.99;36.46]), intensive care unit admission (OR:1.26 [95%CI:1.08;1.47]), and hospitalization (OR: 1.62 [95%CI:1.53;1.71]), whilst the presence of care complexity factors was a protective factor of discharge against medical advice (OR:0.64 [95%CI:0.55;0.74]). Conclusion: The discharge destinations from the ED showed strong associations with the patient’s complexity factors. Health professionals should consider these relationships for the design of early detection strategies and as an aid in decision-making, to ensure equity and quality of care.Shahid Beheshti University of Medical Sciences2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion12 p.application/pdfhttps://hdl.handle.net/2445/225488Articles publicats en revistes (Infermeria Fonamental i Clínica)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.22037/aaemj.v13i1.2517Archives of Academic Emergency Medicine, 2024, vol. 13, num.1https://doi.org/10.22037/aaemj.v13i1.2517cc-by-nc (c) Urbina, A. et al., 2024http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2254882026-05-29T05:05:01Z
dc.title.none.fl_str_mv Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
title Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
spellingShingle Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
Urbina, Andrea
Serveis d'urgències hospitalàries
Personal sanitari
Ingressos i altes en els hospitals
Satisfacció dels pacients
Hospital emergency services
Medical personnel
Hospital admission and discharge
Patient satisfaction
title_short Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
title_full Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
title_fullStr Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
title_full_unstemmed Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
title_sort Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
dc.creator.none.fl_str_mv Urbina, Andrea
Adamuz, Jordi
Juvé Udina, Eulàlia
Peñafiel, Judith
Munoa-Urruticoechea, Virginia
González Samartino, Maribel
Delgado-Hito, Pilar
Jacob, Javier
Romero García, Marta
author Urbina, Andrea
author_facet Urbina, Andrea
Adamuz, Jordi
Juvé Udina, Eulàlia
Peñafiel, Judith
Munoa-Urruticoechea, Virginia
González Samartino, Maribel
Delgado-Hito, Pilar
Jacob, Javier
Romero García, Marta
author_role author
author2 Adamuz, Jordi
Juvé Udina, Eulàlia
Peñafiel, Judith
Munoa-Urruticoechea, Virginia
González Samartino, Maribel
Delgado-Hito, Pilar
Jacob, Javier
Romero García, Marta
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Serveis d'urgències hospitalàries
Personal sanitari
Ingressos i altes en els hospitals
Satisfacció dels pacients
Hospital emergency services
Medical personnel
Hospital admission and discharge
Patient satisfaction
topic Serveis d'urgències hospitalàries
Personal sanitari
Ingressos i altes en els hospitals
Satisfacció dels pacients
Hospital emergency services
Medical personnel
Hospital admission and discharge
Patient satisfaction
description Introduction: Emergency department discharge destination is an important topic in both clinical practice and management.This study aimed to analyze the association of Care Complexity Individual Factors (CCIFs) with discharge destinations in patients who visit the emergency department (ED). Methods: This is a retrospective cohort study with consecutive sampling, including all patients who visited the ED of a tertiary hospital during 2021-2022. Data were collected from electronic health records. The main study outcomes were discharge destinations (mortality, intensive care unit admission, hospitalization, left without being seen/discharge against medical advice, and home discharge) and 26 CCIFs. Independent multinomial logistic regression was used for assessing the association of each factor and the discharge destinations, adjusted for age, sex, and triage level. All analyses were performed with R, version 4.3.2. Results: A total of 35,383 patients were included. Of these, 60.8% were home discharged, 34.1% were hospitalized, 2.6% were transferred to the intensive care unit, 2.1% were left without being seen, and 0.4% died. The presence of CCIFs was a risk factor of ED mortality (odds ratio (OR): 13.49 [95% confidence interval (CI): 4.99;36.46]), intensive care unit admission (OR:1.26 [95%CI:1.08;1.47]), and hospitalization (OR: 1.62 [95%CI:1.53;1.71]), whilst the presence of care complexity factors was a protective factor of discharge against medical advice (OR:0.64 [95%CI:0.55;0.74]). Conclusion: The discharge destinations from the ED showed strong associations with the patient’s complexity factors. Health professionals should consider these relationships for the design of early detection strategies and as an aid in decision-making, to ensure equity and quality of care.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/225488
url https://hdl.handle.net/2445/225488
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.22037/aaemj.v13i1.2517
Archives of Academic Emergency Medicine, 2024, vol. 13, num.1
https://doi.org/10.22037/aaemj.v13i1.2517
dc.rights.none.fl_str_mv cc-by-nc (c) Urbina, A. et al., 2024
http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc (c) Urbina, A. et al., 2024
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 12 p.
application/pdf
dc.publisher.none.fl_str_mv Shahid Beheshti University of Medical Sciences
publisher.none.fl_str_mv Shahid Beheshti University of Medical Sciences
dc.source.none.fl_str_mv Articles publicats en revistes (Infermeria Fonamental i Clínica)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869425577974300672
score 15,811543

Similares en LA Referencia