ABSTRACT
INTRODUCTION: The Ministry of Health and Prevention of the UAE acquired an electronic medical record system (Wareed) through which they incorporated the Emergency Severity Index as the standard triaging tool. This raised the need to review population dynamics and the accuracy of triage performed by the health-care providers utilizing the tool. OBJECTIVE: This research aimed to study demographics and dynamics of the population presenting to emergency departments (EDs) during 2018, evaluate the accuracy of triage assessment using comparative analysis techniques, and determine relationships between patient factors (severity of illness, age-group) and the accuracy of triage. METHODS: This was an observational study that aimed to ascertain findings from ED data over 1 year (January 2018-December 2018) and explore factors associated with reduced accuracy in acuity assignment. We employed comparative analysis to measure the level of agreement between standard guidelines and local findings. RESULTS: A total of 576,154 patients visited EDs in 2018, of which 54.4% were male. A statistically significant increase in length of stay with increasing severity of illness was observed (Kruskal-Wallis test). Overall triage accuracy was 41.6%, with a positive association with increasing severity of illness. We found a positive association between severity of illness and accuracy of triage (OR 0.14, p=0). We also found on logistic regression that the age-group 11-20 years had the highest probability of accurate triage acuity (R 2=0.41, p=0). CONCLUSION: Conducted on a very large data set from the UAE, our study reflects upon population dynamics and triage accuracy distribution among different variables. This study paves the way for further in-depth analysis of factors that may impact triage accuracy within EDs, and utilizing a similar approach it can be replicated in other settings as well.
ABSTRACT
BACKGROUND: Tobacco is the single leading and most preventable cause of death in today's worlds and responsible for six of the eight leading mortality causes in the world. Diseases related to tobacco use are known to cause about 5.4 million deaths every year, 80% of which are contributed by the developing world, and this toll is estimated to increase up to 8 million deaths per year by 2030. This study was conducted to determine the number of women who were offered counselling regarding cessation of tobacco use by all health care providers (medical and alternate), in rural Sindh, Pakistan. METHODS: This cross-sectional survey was conducted during January to March, 2008 in District Khairpur, Sindh, Pakistan. A validated, pre-tested, translated questionnaire was used to collect the data from 502, adult women (aged between 18-60 years). These women were asked about the type of health provider they visited in the past 12 months and practices of provider regarding tobacco control including cessation and advice. RESULTS: A large majority of women (nearly 71%) were illiterate, and 44% of women were in the age group 18-24 years. High prevalence (10%) of adult women were smokers. Only 12% of the total women who visited physicians during this time period were asked about their smoking status as compared to 7% who visited hakims and 13% who were approached by lady health visitors. CONCLUSION: A very small segment of the women users of health care system is enquired and counselled about tobacco use in any form by the health providers in Rural Sindh. Revisiting practices for health care professionals is urgently needed to address inevitable tobacco use in the region.
