Limitations and consequences of public health models centred on hospitals and lacking connections with territorial and home‐based social and health services
Dublin Core
Title
Limitations and consequences of public health models centred on hospitals and lacking connections with territorial and home‐based social and health services
Subject
Frequent users, Emergency Department, Emergency Room, Public Health Model, Triage, Social frailty
Description
Abstract
Background Delayed discharge from hospital to home or other care institutions is a significant problem
and has been investigated in the international scientific literature for many years.
Behind this condition is a health care system based on a hospital-centered concept characterized by a lack of territo-
rial health and social welfare services.
This phenomenon causes two different problems: an excessive length of hospital stay, resulting in slow turnover
of bed utilization; and overcrowding in emergency rooms (ERs).
The phenomenon of frequent users assumes particular importance in this context. These patients repeatedly visit
the emergency department (ED) in the same year because care needs are not met by primary care services.
The authors in this study tried to describe the Frequent users (FUs) population and the variables associated with this
condition.
Materials and methods A retrospective "single-arm" descriptive study was conducted by analysing all accesses
made to the ED of Policlinico Tor Vergata (PTV) from January 1, 2022, to December 31, 2022.
FUs were defined as patients who had 4 or more accesses to PTV ER during the year.
Results A total of 37,800 accesses occurred during the study period. A total of 31,691 users accessed the PS,
with a mean age of 55.8±22.2 years.
There were 359 FU patients (approximately 1%) who had a total of 1984 accesses, corresponding to 5.2% of the total
accesses.
The triage codes for the FU patients were red, 2%; orange, 21%; blue, 45%; green, 26%; white, 5%; and not performed,
1%.
Considering the 1984 FU accesses, the most frequently attributed "main problems" in the ED were "other symp-
toms or disorders" (54%), "psychomotor agitation" (12%), "trauma or burn" (8%), "abdominal pain" (6%), "chest pain"
(4%), "dyspnea" (4%) and "urological symptoms or disorders" (4%). Multivariate analysis revealed that the main
Background Delayed discharge from hospital to home or other care institutions is a significant problem
and has been investigated in the international scientific literature for many years.
Behind this condition is a health care system based on a hospital-centered concept characterized by a lack of territo-
rial health and social welfare services.
This phenomenon causes two different problems: an excessive length of hospital stay, resulting in slow turnover
of bed utilization; and overcrowding in emergency rooms (ERs).
The phenomenon of frequent users assumes particular importance in this context. These patients repeatedly visit
the emergency department (ED) in the same year because care needs are not met by primary care services.
The authors in this study tried to describe the Frequent users (FUs) population and the variables associated with this
condition.
Materials and methods A retrospective "single-arm" descriptive study was conducted by analysing all accesses
made to the ED of Policlinico Tor Vergata (PTV) from January 1, 2022, to December 31, 2022.
FUs were defined as patients who had 4 or more accesses to PTV ER during the year.
Results A total of 37,800 accesses occurred during the study period. A total of 31,691 users accessed the PS,
with a mean age of 55.8±22.2 years.
There were 359 FU patients (approximately 1%) who had a total of 1984 accesses, corresponding to 5.2% of the total
accesses.
The triage codes for the FU patients were red, 2%; orange, 21%; blue, 45%; green, 26%; white, 5%; and not performed,
1%.
Considering the 1984 FU accesses, the most frequently attributed "main problems" in the ED were "other symp-
toms or disorders" (54%), "psychomotor agitation" (12%), "trauma or burn" (8%), "abdominal pain" (6%), "chest pain"
(4%), "dyspnea" (4%) and "urological symptoms or disorders" (4%). Multivariate analysis revealed that the main
Creator
Lavinia Gentile1*, Martina Scaramella1
, Giuseppe Liotta2
, Andrea Magrini2
, Maria Franca Mulas2
,
Giuseppe Quintavalle3 and Leonardo Palombi2,4
, Giuseppe Liotta2
, Andrea Magrini2
, Maria Franca Mulas2
,
Giuseppe Quintavalle3 and Leonardo Palombi2,4
Source
https://doi.org/10.1186/s12245-024-00641-1
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Lavinia Gentile1*, Martina Scaramella1
, Giuseppe Liotta2
, Andrea Magrini2
, Maria Franca Mulas2
,
Giuseppe Quintavalle3 and Leonardo Palombi2,4, “Limitations and consequences of public health models centred on hospitals and lacking connections with territorial and home‐based social and health services,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12347.