P96 | Medical admission area as possible reply to Emergency Department overcrowding and boarding: model and preliminary report from hospitals of Azienda USL Toscana Centro
L. Masotti1, D. Bruni2, G. Panigada3, A. Fortini4, G. Nenci5, M. Fabbri6, F. Risaliti7, M. Bulgaresi8, E. Schipani1, E. Benvenuti9 | 1Medicina Interna II, Ospedale San Giuseppe, Empoli, 2Medicina Interna, Ospedale Santo Stefano, Prato, 3Medicina Interna, Ospedale SS Cosma e Damiano, Pescia (PT), 4Medicina Interna, Ospedale San Giovanni di Dio, Firenze, 5Medicina Interna, Ospedale San Jacopo, Pistoia, 6Medicina Interna, Ospedale Santissima Annunziata, Firenze, 7Medicina Interna, Ospedale Mugello, Firenze, Borgo San Lorenzo (FI), 8Geriatria, Ospedale Santissima Annunziata, Firenze, 9Direttore Dipartimento Medicina Multidimensionale, Azienda USL Toscana Centro, Italy
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Premises and Purpose of the study: Ministry of Health and italian Regions have issued recommendations to reduce boarding and overcrowding of Emergency Departments (EDs). The early taking charge by Specialists after initial diagnostic and therapeutic framework by ED physicians, represents a key point. In 2022 the Azienda USL Toscana Centro (AUTC) arranged to create Areas defined “Aree Mediche di Ammissione (AMA)” outside the EDs in which haemodinamically stable patients requiring hospitalization for medical reasons or taking charge for rapid turn-over medical problems could be allocated and managed by Internal Medicine (IM) and/or Geriatrics physicians. The aim of our study was to report on the results of AMAs of AUTC in 2023.
Materials and Methods: We retrospectively analized data of patients admitted the AMAs of AUTC in 2023.
Results: In the analyzed period, 17.624 patients, corresponding to about 5% of EDs admissions and 45% of IM wards admissions, have been taken care by the AMAs. Of them 60% were admitted in medical wards, 30% were discharged home, 9% had other destination such as discharged with transfer in territorial structures or discharged home with close geriatric follow-up, 1% died in AMAs. Mean stay from ED arrival was 43 hours in patients admitted in wards, 68 hours in patients discharged home, 61 hours in patients with other destination.
Conclusions: Preliminary results support the role of AMAs as a concrete option for healtcare system to reduce overcrowding and boarding of patients in the EDs and make admission in medical wards more appropriate.
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