Associated Factors of Unnecessary Nighttime Visits to the Emergency Room at Buriram Hospital

Abstract

This research employed a mixed-methods approach, incorporating both quantitative and qualitative studies. The quantitative study was conducted first, followed by a qualitative study to examine factors related to unnecessary visits to the emergency room during nighttime and to explore the feelings of medical personnel regarding the care of such patients. The study included a case-control design, reviewing medical records of 100 cases each of necessary and unnecessary nighttime visits. Additionally, a phenomenological study was conducted through in-depth interviews with eight emergency room staff. The quantitative results were presented as percentages and means. Variables with a p-value of less than 0.05 from univariate analysis were further analyzed using multivariable logistic regression, with results presented as Adjusted Odds Ratio (AdjOR) and 95% confidence intervals. The qualitative data were analyzed using content analysis.

The findings indicated that there was a statistically significant difference in waiting times between patients with necessary and unnecessary nighttime visits (p-value=0.032). After controlling for other factors using multivariable logistic regression, it was found that non-elderly patients (p-value=0.0012) were associated with unnecessary emergency room visits during nighttime. Furthermore, the in-depth interviews revealed that some patients were unable to visit during regular hours or lacked confidence in managing minor health issues themselves. This led to stress, fatigue, and pressure among medical personnel, resulting in conflicts between patients and staff. Non-elderly patients were identified as a factor contributing to unnecessary nighttime visits, which increased the workload of medical staff and caused fatigue. Therefore, policies should be implemented to extend outpatient service hours and educate the public on basic self-care when ill.