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Rev. clín. med. fam ; 1(3): 126-130, feb. 2006. ilus, tab
Article in Es | IBECS | ID: ibc-68977

ABSTRACT

Objetivo. Conocer los motivos por los que los pacientes acuden a urgencias hospitalarias sin pasar por urgencias de Atención Primaria (AP).Diseño. Estudio descriptivo transversal.Emplazamiento. Urgencias hospitalarias.Participantes. Pacientes atendidos en urgencias entre junio 2004 y febrero 2005 seleccionados aleatoriamente.Mediciones principales. Cuestionario anónimo preguntando: edad, sexo, tipo de derivación, distanciaal hospital, confi anza en urgencias hospitalarias, urgencias AP y médico AP, motivo de utilizacióndel servicio, duración del proceso e ingresos.Resultados. Se realizaron 508 entrevistas, el 48,2 % hombres, con edad media 38,97 (DE 24,21). Acudieron no derivados el 66,7 % (IC 95 %: 62,42 – 70,79), sin diferencias estadísticamente signifi cativaspor sexo o edad respecto al tipo de derivación. El tiempo medio en llegar al hospital los no derivadosfue 23,25 minutos (DE 15,17) frente a 28,03 (DE 16,12) en los derivados (t = -3,07; p< 0,01). Confianza en urgencias AP alta/muy alta en el 37,7 % de los no derivados frente al 60,2 % de los derivados(χ2 :18,07; p< 0,01). Motivos de no acudir a urgencias AP: pruebas complementarias (21,2%), especialista (18%) y desconfi anza en urgencias AP (16,8%). Ingresó el 5,3% de no derivados frente al 19,3% de derivados (χ2:95,79; p< 0,01). En análisis multivariante infl uye, en acudir directamente al hospital, la desconfi anza en urgencias AP (OR: 2,61; IC 95 %: 1,64-4,15) y la cercanía al hospital (OR: 1,02; IC 95%: 1-1,03).Conclusiones. Dos tercios de los pacientes acuden directamente al hospital, siendo la cercanía y ladesconfi anza en urgencias AP las principales causas


Objective. To know why patients goes directly to emergency department in hospital avoiding emergencyin primary care level.Design. Descriptive and transversal study.Setting. Emergency department in hospitalSubjects. Patients who went hospital emergency department between June’04 and February’05 withrandom selectionPrincipal measurements. Anonymous questionnaire with questions following: age, sex, sending origin,distance from home to hospital, confi dence in emergency hospital department, emergency serviceat primary care level and doctor, reason why went to emergency department, duration of process andadmission in hospital fl at.Results. Have been done 508 interviews, 48,2% male, average age 38.97 (SD 24,21). 66,7% (IC 95%: 62,42 – 70,79) went without document from primary care level, without differences with statisticalsignifi cance by sex, age or origin. The average arriving time was 23,25 minutes (SD 15,17) in thecase of not previous stop at primary care level vs. 28,03 (SD 16,12) with previous stop (t = - 3,07; p<0,01). The confi dence related about emergency at primary care level was high/very high in 37,7% inthe case of not previous stop in primary care vs. 60,2% with previous stop (X2: 18,07; p<0,01). Thereasons for not visit primary care level are: demand of complementary trials (21,2%), specialized consultancy(18%) and poor confi dence in emergency care at primary level (16,8 %). Was admitted in fl at 5,3% in the case of not previous stop vs. 19,3% in the case of patients with previous stop (X2: 95,79; p<0,01). The multivariant research show that have infl uenced to visit directly hospital, poor confi dence in emergency service at primary care level (OR: 2,61; IC 95 %:1,64 – 4,15) and the close distance to hospital (OR: 1,02; IC 95 %: 1-1,03).Conclusions. 66,66 of patients went directly to hospital, been the more important reasons the closedistance to hospital and the poor confi dence in emergency service at primary care level


Subject(s)
Humans , Emergency Medical Services , Emergency Service, Hospital , Primary Health Care , Health Services Misuse/statistics & numerical data , Health Care Surveys/statistics & numerical data
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