ABSTRACT
Objetivo: Determinar el impacto, sobre la utilización de servicios sanitarios y la ansiedad del paciente,de un programa de atención telefónica durante el mes siguiente al alta hospitalaria de una unidad de cirugía traumatológica, junto con análisis presupuestario.Método: Estudio experimental en 604 pacientes, que constituyeron los grupos experimental y control.El grupo experimental dispuso de atención telefónica para solventar dudas durante el mes siguiente alalta. Al finalizar se registraron, en ambos grupos, si habían acudido a urgencias, al médico de familia o reingresado, y el resultado de un test de ansiedad, que constituyeron las variables resultado. El análisis dedatos incluyó análisis multivariados de regresión logística y lineal, y cálculo del impacto presupuestario del programa en tres escenarios (Hospital, Servicio Andaluz de Salud, Sistema Nacional de Salud).Resultados: Se atendieron 73 consultas telefónicas de 60 pacientes, casi la mitad de ellas por dudas respecto al régimen terapéutico. Para la variable resultado «asistencia a los servicios de urgencias», en el análisis multivariado los pacientes sin atención telefónica tenían una odds ratio de 1,8, ajustada por lasvariables «días de estancia hospitalaria», «ansiedad del paciente» y «comprensión de las indicaciones alalta». Para el resto de las variables resultado no hubo diferencias entre ambos grupos. El análisis de costes demostró la posibilidad de implantar el programa con un coste de 1,65 euros por paciente intervenido.Conclusiones: El programa fue eficaz para disminuir las visitas a urgencias, a un coste reducido (AU)
Objective: To determine the impact of a 1-month telephone care program after hospital discharge from a trauma surgery unit on health services utilization and patient anxiety and to perform a budgetaryanalysis. Methods: We carried out an experimental study in 604 patients who formed an experimental and a control group. The experimental group was offered telephone care to resolve doubts during the firstmonth after discharge. After this period, data were collected from both groups on the following outcomevariables: visits to the emergency department or family physician, hospital readmissions, and the resultsof an anxiety test. Data analyses included logistic and linear multivariate analyses and calculation of thebudgetary impact of the program on the hospital, the Andalusian Health Service, and the National Health System.Results: A total of 73 telephone consultations were conducted with 60 patients, almost half for doubts about the therapeutic regimen. For the outcome variable visit to emergency department, the groupwithout telephone care had an odds ratio of 1.8 in the multivariate analysis adjusted for the other independentvariables: days of hospital stay, patient anxiety and comprehension of discharge indications.No differences between groups were found in the remaining outcome variables. The budgetary analysis demonstrated the possibility of implementing the program at a cost of 1.65 D per patient.Conclusions: This program proved effective in reducing visits to the emergency department at a low cost (AU)
Subject(s)
Humans , Continuity of Patient Care/organization & administration , Postoperative Care/methods , Trauma Centers/organization & administration , Evaluation of the Efficacy-Effectiveness of Interventions , Hotlines , Patient Discharge/trends , Postoperative Complications/epidemiologyABSTRACT
OBJECTIVE: To determine the impact of a 1-month telephone care program after hospital discharge from a trauma surgery unit on health services utilization and patient anxiety and to perform a budgetary analysis. METHODS: We carried out an experimental study in 604 patients who formed an experimental and a control group. The experimental group was offered telephone care to resolve doubts during the first month after discharge. After this period, data were collected from both groups on the following outcome variables: visits to the emergency department or family physician, hospital readmissions, and the results of an anxiety test. Data analyses included logistic and linear multivariate analyses and calculation of the budgetary impact of the program on the hospital, the Andalusian Health Service, and the National Health System. RESULTS: A total of 73 telephone consultations were conducted with 60 patients, almost half for doubts about the therapeutic regimen. For the outcome variable "visit to emergency department", the group without telephone care had an odds ratio of 1.8 in the multivariate analysis adjusted for the other independent variables: days of hospital stay, patient anxiety and comprehension of discharge indications. No differences between groups were found in the remaining outcome variables. The budgetary analysis demonstrated the possibility of implementing the program at a cost of 1.65 per patient. CONCLUSIONS: This program proved effective in reducing visits to the emergency department at a low cost.
Subject(s)
Continuity of Patient Care , Patient Discharge , Telephone , Trauma Centers , Wounds and Injuries/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Wounds and Injuries/surgery , Young AdultABSTRACT
OBJECTIVE: The objective of this study was to explore the possible association between the anxiety level of patients and their satisfaction with different aspects of healthcare. METHOD: This analytical cross-sectional study included 301 patients undergoing scheduled trauma surgery from October 2004 to May 2005 at the Virgen de las Nieves University Hospital in Granada (Spain). They completed a sociodemographic and clinical questionnaire before their discharge and, at 15 days after discharge, they responded to an ad hoc questionnaire comprising three items (satisfaction with information received, privacy and comfort of the setting, and friendliness of healthcare professionals), and were scored on an interviewer-administered Zung anxiety scale. Descriptive analysis and unadjusted logistic regression were performed for each factor, followed by multivariate logistic regression to model the association between satisfaction and anxiety with study of confounding variables. RESULTS: For each higher point in the Zung test, patients had a 4% higher risk of feeling dissatisfied with the information received, an 8% higher risk of dissatisfaction with the hospital setting and a 6% higher risk of dissatisfaction with the friendliness of healthcare personnel. CONCLUSION: A higher anxiety level in the patient was associated with greater dissatisfaction with the three healthcare aspects studied.
