Factors Associated with Inpatient Care Received in Emergency Patient Referred from Primary Care Cluster to Tertiary Care, Trang Hospital

Abstract

The accessibility of primary care services had led to an increase in emergency patients requiring referral to tertiary care hospitals. Receiving inpatient care indicates the importance of referring patients. The objective of this study was to identify factors associated with the care services among emergency in-patients who were referred from family doctor clinics. The study design was a retrospective analytic study in emergency patient referred from primary care cluster to Trang hospital between February to September 2023. Data collection from electronic medical records then analyzed for correlation with receiving inpatient care by using multivariate logistic regression analysis. Results: A total of 140 patients referred from primary care cluster to Trang hospital were eligible with an average age of 48.8+21.45 years. Females were 1.37 times than males and 106 patients were received inpatient care. Factors that increase the chances of receiving inpatient care were length of stay in emergency department less than 2 hours, history of outpatient care in 7 days, and not having radiology investigation in emergency department (p<0.05). It was also found that not having procedure in emergency department reduced the chances of receiving inpatient care (p<0.05). In conclusion, the development guideline for managing emergency patients in primary care units and referrals is important. Necessary procedures and radiological tests should be performed before referral. This can reduce waiting times in the emergency room and self-visit to the emergency room of the tertiary care hospital for non-critical illnesses. The practice guidelines should be designed to suit each hospital context.