Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia

Abstract Background The Emergency Repartment (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia. Methods This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome. Results The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57–5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85–89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65–51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70–133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23–0.38). Conclusions A low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.

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Perceived Barriers to Primary Care Services Utilization and its Associations with Overall Satisfaction of Patients in Saudi Arabia: A Cross-Sectional Questionnaire-Based Study

Journal of Primary Care & Community Health ◽

10.1177/21501327211014065 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110140

Author(s):

Reem S. AlOmar ◽

Nouf A. AlShamlan ◽

Naheel A. AlAmer ◽

Arwa A. AlThumairi ◽

Bayan M. Almir ◽

...

Keyword(s):

Primary Care ◽

Saudi Arabia ◽

Total Sample ◽

Cross Sectional Study ◽

Categorical Variables ◽

Cross Sectional ◽

Highly Educated ◽

Chi Squared ◽

Primary Physicians ◽

The Impact

Introduction: Primary care plays an integral role in modern healthcare systems. More so in a country that is currently undergoing a reform of its health system. Their remains barriers that hinder patients from seeking medical assistance from primary physicians. This study aims to examine the overall satisfaction of patients toward Primary Healthcare Centers (PHCs) in Saudi Arabia, as well as its association with potential barriers from a sample of patients who presented at the emergency department (ED) for non-urgent cases. Methods: This cross-sectional study sampled 403 patients from King Fahd Hospital of the University. A piloted questionnaire was utilized that included questions on sociodemographics, satisfaction of PHCs, as well as organizational, socioeconomic, access, and patient-doctor relationship barriers using a Likert-scale item response. Chi-squared and Fisher’s Exact tests were used to compare categorical variables, and multivariable logistic regression was used to assess the association between overall satisfaction and all factors and barriers. Results: The sample consisted of 48.1% males and 51.9% females. Only 5.2% of the patients were hospitalized. Of the total sample, 28.3% reported being always satisfied with PHC services. The most reported barriers were organizational barriers and socioeconomic barriers. The regression analysis found that being a female, highly educated, have high organizational, and patient-doctor relationship were independent predictors for low overall satisfaction with PHCs. Conclusion: Findings from this study should allow healthcare planners and policy makers to reduce the impact of these barriers by finding solutions that would target them. This may include strictly implementing policies such as proper implementing of triaging in EDs as well as promoting services that are being provided free of charge at these centers.

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Understanding the impact of the COVID-19 pandemic on a socially deprived UK coastal town: a preliminary exploratory analysis of health and socioeconomic data

10.1101/2021.12.22.21268232 ◽

2021 ◽

Author(s):

Maddy French ◽

Mark Spencer ◽

Mike Walker ◽

Afzal Patel ◽

Neil Clarke ◽

...

Keyword(s):

Primary Care ◽

Hospital Admissions ◽

Exploratory Analysis ◽

Social Outcomes ◽

Socioeconomic Outcomes ◽

Chi Squared ◽

Service Activity ◽

Indirect Impacts ◽

The Uk ◽

The Impact

Introduction In addition to the direct impact of COVID-19 infections on health and mortality, a growing body of literature indicates there are wide-ranging indirect impacts of the COVID-19 pandemic and associated public health measures on population health and wellbeing. Exploring these indirect impacts in the context of a socially deprived UK coastal town will help identify priority areas to focus COVID-19 recovery efforts on. Methods Data on primary care diagnosis, hospital admissions, and several socioeconomic outcomes between 2016 and Spring 2021 in the UK town of Fleetwood were collected and analysed in an exploratory analysis looking at pre- and post- COVID-19 patterns in health and social outcomes. Weekly and monthly trends were plotted by time and differences between periods examined using Chi-squared and t-tests. Results Initial falls in hospital admissions and diagnoses of conditions in primary care in March 2020 were followed by sustained changes to health service activity for specific diagnostic and demographic groups, including for chronic kidney disease and young people. Increases in the number of people receiving Universal Credit and children eligible for free school meals appear to be greater for those in the least deprived areas of the town. Discussion These exploratory findings provide initial evidence of the sustained impact of the pandemic across several health and social outcomes. Examining these trends in multivariate analyses will further test these associations and establish the strength of the medium term impact of the pandemic on the population of this coastal town. Advanced modelling of this data is ongoing and will be published shortly.

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Obesity contributes toward hypertension in young and older adult

Zinc supplementation improves heme biosynthesis in rats exposed to lead ◽

10.18051/univmed.2016.v35.96-104 ◽

2016 ◽

Vol 35 (2) ◽

pp. 96 ◽

Cited By ~ 1

Author(s):

Julianty Pradono ◽

Sintawati Sintawati

Keyword(s):

Central Obesity ◽

Blood Pressure Measurement ◽

Population Data ◽

Total Sample ◽

National Health Survey ◽

Age Group ◽

Healthy Weight ◽

General Obesity ◽

Cross Sectional ◽

The Impact

Background Obesity and hypertension are independent risk factors in the increasing prevalence of non-communicable diseases. The proportion of obesity in Indonesia has increased in the last 5 years according to the National Health Survey. The purpose of this research was to obtain the contribution of obesity toward hypertension in the age group of 18 years and above. Methods An observational study of cross-sectional design was conducted using the National Basic Health Research 2013 population data. The total sample of subjects was 2,741,297 from 33 provinces in Indonesia. Data were collected through interviews, blood pressure measurement, and anthropometry. Analysis of categorical data was by means of the chi-square statistical test, followed by calculation of the attributable fraction in the population, and analysis of factors influencing the impact fraction. Results The prevalence of general obesity (BMI>25 kg/m2) was 31.5% in males and 48.0% in females, while central obesity was 20.9% in males and 42.5% in females. In females with general obesity the risk of hypertension was 1.84 (95% CI: 1.82-1.86) times higher than in those with normal BMI. If general obesity and central obesity can be reduced, the prevalence of hypertension may be reduced by 2.9% in males and by 12.2% in females. Conclusion The prevalence of hypertension in the age group of 18 years or more can be reduced by 2.9% in males and by 12.2% in females, by overcoming the contribution of obesity. Therefore efforts should be geared towards promoting healthy eating habits and maintaining a healthy weight through health education.

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Examining and investigating the impact of demographic characteristics and chronic diseases on mortality of COVID-19: Retrospective study

PLoS ONE ◽

10.1371/journal.pone.0257131 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257131

Author(s):

Abbas Al Mutair ◽

Alya Al Mutairi ◽

Saad Alhumaid ◽

Syed Maaz Abdullah ◽

Abdul Rehman Zia Zaidi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Saudi Arabia ◽

Binary Logistic Regression ◽

Demographic Characteristics ◽

Control Measures ◽

Effective Control ◽

Diabetic Patients ◽

History Of ◽

And Gender ◽

The Impact

Background Epidemiological features characterization of COVID-19 is highly important for developing and implementing effective control measures. In Saudi Arabia mortality rate varies between 0.6% to 1.26%. The purpose of the study was to investigate whether demographic characteristics (age and gender) and non-communicable diseases (Hypertension and Diabetes mellitus) have a significant association with mortality in COVID-19 patients. Methods Prior to data collection, an expedite approval was obtained from Institutional Review Board (IRB Log No: RC. RC20.09.10) in Al Habib Research Center at Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia. This is a retrospective design where we used descriptive and inferential analysis to analyse the data. Binary logistic regression was done to study the association between comorbidities and mortality of COVID-19. Results 43 (86%) of the male patients were non-survivors while 7 (14%) of the female patients were survivors. The odds of non-survivors among hypertensive patients are 3.56 times higher than those who are not having a history of Hypertension (HTN). The odds of non-survivors among diabetic patients are 5.17 times higher than those who are not having a history of Diabetes mellitus (DM). The odds of non-survivors are 2.77 times higher among those who have a history of HTN and DM as compared to those who did not have a history of HTN and DM. Conclusions Those patients that had a history of Hypertension and Diabetes had a higher probability of non-survival in contrast to those who did not have a history of Diabetes and hypertension. Further studies are required to study the association of comorbidities with COVID-19 and mortality.

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Tuberculosis in Saudi Arabia: Prevalence between Saudis and Non-Saudis from 2013 to 2018 with a special concern about regions of the KSA

Journal of Clinical & Experimental Immunology ◽

10.33140/jcei.04.06.02 ◽

2019 ◽

Vol 4 (6) ◽

Keyword(s):

Saudi Arabia ◽

Migrant Workers ◽

Action Plan ◽

Age Groups ◽

Incidence Rates ◽

Arab Countries ◽

Surveillance Data ◽

Significance Level ◽

Chi Squared ◽

The Impact

The Kingdom of Saudi Arabia is one of the largest Arab countries with a moderate annual problem of tuberculosis that is either pulmonary or extra-pulmonary. TB is still one of the most significant health troubles in the KSA, affecting different nationalities (Saudis, non-Saudis), ages, provinces, and genders. The control of TB still faces some challenges in different provinces of the KSA. Data were collected, arranged, analyzed and presented in tables and figures. In this retrospective study, we appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). Data were handled using Microsoft Excel and SPSS version 23. Data were checked for normality using Shapiro-Wilk normality test at 0.05 levels to determine whether they are parametric or nonparametric. Chi-squared, Kruskal Wallis, and analysis of variance tests were used to evaluate trends at a significance level of p< 0.05. Statistical analyses were performed using IBM-SPSS version 23 for Mac OS. We appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). The data included the region of the country (province), age, sex, and nationality (Saudis, non-Saudis). The study evaluated the impact of TB on various nationalities (Saudis and non-Saudis), age groups (0-14, 15-34, 35-55, more than 55 years old), and genders (males and females). Non-Saudis had a higher incidence rate than Saudis in 2013-2018. The number of cases and incidence rates of TB recorded in males between 2013 to 2018 were about two to three times greater than estimates for females. The Makkah, Riyadh, and Jeddah regions attract enormous numbers of non-Saudi migrant workers, who account for ~60% of all TB cases in the KSA. Assessing the main TB risk factors contributing to high TB rates in non-Saudi workers is essential. Furthermore, periodical accurate studies, including evidence-based studies for optimum surveillance, avoidance, spread risk, inspection, control procedures and treatment of TB, should be conducted. These assessments would lead to evaluating the strengths and weaknesses of KSA-NTP’s TB action plan.

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Impact of emergency hospital admissions on patterns of primary care prescribing: a retrospective cohort analysis of electronic records in England

British Journal of General Practice ◽

10.3399/bjgp20x709385 ◽

2020 ◽

Vol 70 (695) ◽

pp. e399-e405

Author(s):

Rachel Denholm ◽

Richard Morris ◽

Sarah Purdy ◽

Rupert Payne

Keyword(s):

Hospital Admission ◽

Retrospective Cohort ◽

Hospital Admissions ◽

Cohort Analysis ◽

Post Discharge ◽

Emergency Hospital ◽

Obstetrics And Gynaecology ◽

Emergency Hospital Admission ◽

Retrospective Cohort Analysis ◽

The Impact

BackgroundLittle is known about the impact of hospitalisation on prescribing in UK clinical practice.AimTo investigate whether an emergency hospital admission drives increases in polypharmacy and potentially inappropriate prescriptions (PIPs).Design and settingA retrospective cohort analysis set in primary and secondary care in England.MethodChanges in number of prescriptions and PIPs following an emergency hospital admission in 2014 (at admission and 4 weeks post-discharge), and 6 months post-discharge were calculated among 37 761 adult patients. Regression models were used to investigate changes in prescribing following an admission.ResultsEmergency attendees surviving 6 months (N = 32 657) had a mean of 4.4 (standard deviation [SD] = 4.6) prescriptions before admission, and a mean of 4.7 (SD = 4.7; P<0.001) 4 weeks after discharge. Small increases (<0.5) in the number of prescriptions at 4 weeks were observed across most hospital specialties, except for surgery (−0.02; SD = 0.65) and cardiology (2.1; SD = 2.6). The amount of PIPs increased after hospitalisation; 4.0% of patients had ≥1 PIP immediately before pre-admission, increasing to 8.0% 4 weeks post-discharge. Across hospital specialties, increases in the proportion of patients with a PIP ranged from 2.1% in obstetrics and gynaecology to 8.0% in cardiology. Patients were, on average, prescribed fewer medicines at 6 months compared with 4 weeks post-discharge (mean = 4.1; SD = 4.6; P<0.001). PIPs decreased to 5.4% (n = 1751) of patients.ConclusionPerceptions that hospitalisation is a consistent factor driving rises in polypharmacy are unfounded. Increases in prescribing post-hospitalisation reflect appropriate clinical response to acute illness, whereas decreases are more likely in patients who are multimorbid, reflecting a focus on deprescribing and medicines optimisation in these individuals. Increases in PIPs remain a concern.

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Impact of the Nutrition-Friendly School Initiative: analysis of anthropometric and biochemical data among school-aged children in Ouagadougou

Global Health Promotion ◽

10.1177/1757975918789350 ◽

2019 ◽

Vol 27 (2) ◽

pp. 26-34 ◽

Cited By ~ 1

Author(s):

Christelle Elkhouri Edde ◽

Helene Delisle ◽

Charles Dabone ◽

Malek Batal

Keyword(s):

Primary Schools ◽

Vitamin A Deficiency ◽

Intervention Group ◽

Total Sample ◽

Biochemical Data ◽

Serum Retinol ◽

Double Burden ◽

Chi Squared ◽

And Control ◽

The Impact

The Nutrition-Friendly School Initiative was developed in 2006 to counter the double burden of malnutrition and implemented on a pilot basis in primary schools in Ouagadougou (Burkina Faso) in 2009. A baseline study was conducted in intervention and control schools and repeated in 2014 to assess the impact. This paper reports on anthropometric and biochemical data in the final and baseline surveys. Both studies were conducted in the fifth grade classes of the same primary schools in Ouagadougou. Six intervention schools had been selected and matched at baseline with six control schools. The total sample consisted of 699 and 651 pupils in 2009 and 2014, respectively. Anthropometric and hemoglobin measurements were performed on all children, whereas serum retinol was measured in a random subsample to assess Vitamin A Deficiency (VAD). Independent t-tests and chi-squared tests were used for comparison of means and proportions, respectively, and multiple logistic regressions were conducted to examine associations between nutritional parameters and school characteristics. Final rates of anaemia and VAD were 32.6% and 26.1%, respectively, down from 40.4% and 38.7% at baseline. The final prevalence rate of stunting was 8.1%, thinness was 8.7% and overweight/obesity was 4.4%. Thinness declined significantly in 2014 compared to 2009, but there was no change in the rate of stunting even though the rate of overweight/obesity showed an upward trend. When comparing intervention with control schoolchildren, the only significant differences found in the final survey were less thinness and less anaemia in the intervention children. However, the prevalence of anaemia was also significantly lower in the intervention group at baseline. Our results point to a significant improvement in the nutritional status of schoolchildren in Ouagadougou and suggest a positive, although modest, role for the Nutrition-Friendly School Initiative in reducing thinness, but not overweight.

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Factors that Influence Attitude of Artisanal Fishers towards Conservation Measures in Ekperiama (Ekperikiri), Niger Delta

Journal of Environment and Ecology ◽

10.5296/jee.v6i2.7626 ◽

2015 ◽

Vol 6 (2) ◽

pp. 63

Author(s):

Ngodigha, Sabina Alatari ◽

J. F. N Abowei

Keyword(s):

Niger Delta ◽

Binary Logistic Regression ◽

Total Sample ◽

Artisanal Fishers ◽

Conservation Measures ◽

Willingness To Adopt ◽

Fisheries Conservation ◽

Community Cooperation ◽

The Impact ◽

Structured Questionnaire

The study was conducted between September 2013 to April 2015 to determine Artisanal Fishers attitude towards conservation measures in Ekperiama formally known as Ekperikiri in the Niger Delta. With the aid of well-structured questionnaires the desired information were collected and analyzed. Total sample sizes of 260 respondents within the study area were interviewed. Structured questionnaire was divided into four sections to include: socio-psychological characteristics, business information, environmental issues, conservation/ management knowledge. Likert scale was used when applicable. Factor analysis was conducted with the items to determine if underlying construct existed in the sub-scale. Cronbach’s alpha coefficient was used to measure reliability of data and correlation was applied to measure linear relationship between variables. Binary logistic regression technique was used to determine the impact of the independent variables on willingness to adopt fisheries conservation measures. From the analysis, socio-psychological, environmental and institutional barriers are the primary factors influencing fisher’s participation in fisheries conservation programmes in Ekperiama, Ogbia creek. These factors include: fishing experience, awareness, fishers relationship with community, cooperation amongst fishers, relationship with other communities and fishers positive attitude towards preserving nature.

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Intervention analysis of introduction of rotavirus vaccine on hospital admissions rates due to acute diarrhea

Cadernos de Saúde Pública ◽

10.1590/0102-311x00124713 ◽

2014 ◽

Vol 30 (10) ◽

pp. 2101-2111 ◽

Cited By ~ 9

Author(s):

Maria de Lourdes Teixeira Masukawa ◽

Adriana Mayumi Moriwaki ◽

Nelson Shozo Uchimura ◽

Eniuce Menezes de Souza ◽

Taqueco Teruya Uchimura

Keyword(s):

Acute Diarrhea ◽

Hospital Admissions ◽

Health Centers ◽

Intervention Analysis ◽

Rotavirus Vaccine ◽

Age Group ◽

Regional Health ◽

Hospitalization Rates ◽

The Impact ◽

Time Series Methodology

The aim of this study is to investigate the impact of rotavirus vaccine on hospitalization rates for acute diarrhea in children younger than 5 years old after the introduction of the vaccine in 2006. A descriptive analytical observational study was carried out of the hospitalization rates occurred between 2000 and 2011 in 22 Regional Health Centers of Paraná State, Brazil. The effect of the vaccine was assessed by applying the SARIMA/Box-Jenkins time series methodology of intervention analysis, which allows verifying the slopes of the series are different after the introduction of the vaccine and estimating the magnitude of these effects for children younger than five years of age, by age group, for each region center. It was verified a statistically significant reduction by center/month on hospitalization rates for children 1 year old and younger, with averages of 47% and 58%, respectively, in December 2011.

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The Impact of Electronic Commerce on Motivating the Investment in the Kingdom of Saudi Arabia

Journal of International Business Research and Marketing ◽

10.18775/jibrm.1849-8558.2015.55.3002 ◽

2020 ◽

Vol 5 (5) ◽

pp. 13-27

Author(s):

Thair A. Habboush ◽

Badi F. Alanazi

Keyword(s):

Saudi Arabia ◽

State Level ◽

Retail Sector ◽

Age Group ◽

Kingdom Of Saudi Arabia ◽

Substantial Impact ◽

Independent Variables ◽

Study Population ◽

The Subject ◽

The Impact

The study aimed to identify the impact of E-Commerce (regulations and legislations, infrastructure, manpower) on stimulating investment in the Kingdom of Saudi Arabia. We applied the descriptive-analytical method for achieving the study objectives. The questionnaire was administered to collect the data that were then analyzed using the SPSS system to provide answers for related questions and hypotheses. A random sample of 250 volunteering investors was taken, and the number of respondents reached 202 respondents, which represents 81% of the study population. We found that there is a significant impact of E-Commerce on motivating the investment and the existence of a statistically significant correlation between the independent variables as a whole were confirmed. The study also finds a substantial impact of the age variable on the investment in the KSA at the level (α=0.05), and the differences emerge of the age group (31-40). A few recommendations are provided, such as intensifying the studies within the subject domain by using different research methods. Further, another recommendation is to conduct different practical scientific studies on the state level to develop a structured and gradual mechanism for converting 85% of the conventional retail sector to E-Commerce in accordance with the KSA vision in 2030.

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