Explore The Related Factors of Emergency Revisit Among Patients With Cancer in a Medical Center in Northern Taiwan Within 72 Hours: A Retrospective Cohort Nested Study

• Main Authors: YEN, YU-SHAN, 顏郁珊
• Other Authors: CHIANG, LI-CHI
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/87511568994626565590

碩士 === 國防醫學院 === 護理研究所 === 105 === Objectives: This study aims to analyze the relevant factors and dispositions associated with the frequency of repeat emergent department(ED) visits within 72 hours in patients of malignancy disease. The study model is established on Behavioral Model of Health Services Use developed by Ronald M. Andersen. Methods This retrospective study was conducted at a tertiary medical center in northern Taiwan. The medical records from ED cancer patient and collected and reviewed and used for analysis. Results The ED revisits rate within 72 hours was 5.8%. We discovered that gender, type of cancer, cancer staging, metastasis, condition of treatment, types of chronic illness, specialist, health education, triage type, symptoms at visiting, visiting time, duration of ED stay were significantly associated with patient with ED revisit within 72 hours. Furthermore, multivariate logistic regressions analysis showed that patients with radiotherapy, specialist of visiting doctors, patients had received discharge health education, triage category as V, and longer stay time were at high risk for patients with ED revisits within 72 hours. At the aspect of dispositions, patients of cancer with ED revisit had lower hospital admission rate and mortality rate than usual cancer patients. Conclusions In order to elevate the medical care quality of ED, our study suggested that health education should be applied to high risk patient with cancer at ED, adjust the way of discharge health education in ED nurses, out-patient-department referral for lower triaged patients, and shorten the ED waiting time.