Evaluation of patient hospitalization by emergency physician authorization: A single center-retrospective study

Background: By its very nature, the emergency department provides a 24/7 service, and it is a global goal to try to relieve the burden on emergency departments. To this end, we aimed to investigate the impact and appropriateness of the practice of giving emergency physicians authorization to hospitalize patients who require hospitalization but remain in the emergency department on patient outcomes. Methods: This is a single center retrospective study. The study was conducted in a tertiary academic emergency department in Turkey between 01/05/2023 and 31/12/2023, with patients admitted to the wards on the initiative of the emergency physician. Results: The number of patients admitted from the emergency department during the study period was 11927. Among these patients, the ratio of patients whose admission decision was made by the emergency physician was approximately 1% (n=119/11927). The median (IQR) age of patients admitted by initiative was 75 years (65-83) and 47.9% (n=57) were male. The most common admission diagnosis was pneumonia 16.8% (n=20), the most common department consulted was infectious diseases 47.9% (n=57), and the most common department admitted was internal medicine 23.5% (n=28). The mean length of hospital stay (LOHS) for all patients in the study was seven days. The mean length of stay for patients who transferred departments after admission was thirty days (p=0.004). Conclusion: In order to prevent overcrowding in emergency departments, emergency physicians in our country are authorized to admit patients. This authorization is needed for about 1% of all hospitalized patients. If we look at the length of stay of patients admitted with this authorization, we can see that they are admitted for the right and appropriate purposes.