Archives of Hellenic Medicine

Last update:

19-Mar-2025

Arch Hellen Med, 42(3), May-June 2025, 357-364

ORIGINAL PAPER

The correct use of health services of the emergency department.
The case of "Papageorgiou" General Hospital of Thessaloniki

A. Giagkalou,^1,2 K. Katsaliaki^2,3
¹Emergency Department, "Papageorgiou" General Hospital, Τhessaloniki,
²School of Social Sciences, Hellenic Open University, Patras,
³School of Humanities, Social Sciences and Economics, International Hellenic University, Thessaloniki, Greece

OBJECTIVE To investigate the correct or inappropriate use of health services by citizens who visit the emergency department (ED) of a Greek hospital. To consider whether they could be served by another lower health level structure based on whether or not they are admitted to a hospital clinic and the level of risk/severity (ESI) during their triage.

METHOD Data were collected from 300 screening files of patients who were admitted to the ED of the "Papageorgiou" General Hospital of Thessaloniki from December 2022 to February 2023, in relation to the screening level, admission to a clinic, number of examinations, disease coding, demographic data, etc. A statistical analysis of the data was carried out.

RESULTS All ESI category 1 patients made proper use of health care services (all were admitted), while 50% of admissions came from ESI category 2. ESI category 3 patients, who were also the majority, were admitted at a rate of 5.99% of the total, and could be treated in other health care facilities, while something similar also applied to patients in the ESI 4 category (admission rate of 1.66% of the total). Finally, no admissions were recorded in ESI category 5. The majority of cases (82.7%) did not need to be admitted (improper use of health services), while the majority of those admitted (32.7%) were admitted to the department of the pathology clinic. Admissions to specialized clinics (coronary unit, vascular surgery, neurosurgery) constituted 15.4% of admissions. As the age of the patient (p=0.028) and as the ESI severity index increased (p=0.000), so did the number of tests perform (e.g., patients over 75 or with ESI 1 performed more tests).

CONCLUSIONS The high rate of misuse of health care services in the ED causes overcrowding in the EDs and limits the system's ability to respond to real emergencies. The better organization and interconnection of primary care and the correct information of the citizens are possible solutions to the problem.

Key words: Degree of risk/severity ESI, Emergency departments (ED), Health care services, Interconnection of health services, Primary health care, Proper use, Triage systems.