Estimación de la utilización inadecuada del servicio de urgencias de un hospital universitario
- Autores: Adela Carpio Pérez
- Directores de la Tesis: José Antonio Mirón Canelo (dir. tes.), Montserrat Alonso Sardón (dir. tes.), María del Carmen Sáenz González (dir. tes.)
- Lectura: En la Universidad de Salamanca ( España ) en 2008
- Idioma: inglés
- Tribunal Calificador de la Tesis: José Ángel García Rodríguez (presid.), Javier del Pino Montes (secret.), Ana Almaraz Gómez (voc.), Aurora Bueno Cavanillas (voc.), Susana Lorenzo Martínez (voc.)
- Materias:
- Enlaces
- Tesis en acceso abierto en: GREDOS
- Resumen
The objective of this study is to evaluate the appropriateness of the admissions into the emergency room of a University Hospital.Methods: Longitudinal, retrospective and descriptive study of a sample of the total of clinical histories performed in the emergency room of the HUS in 2003. this has been assesed using the PAUHM instrument.Results: Out of the 1068 histories reviewed, 48.2% (515) were men and 51.8% (553) women. average Age WAS 48 TO 21 years (D.T.: 22.56). age range: 13-99 years.71.7%?3 (766) of the patients go to the emergency rooms on their own initiative , being the main reason speed and convenience; more than half, 53.5%?3 (571), come from the city of Salamanca and in 90.9%?2 (971) of the cases is not known how they have arrived at the hospital. The reasons for the consultations were: 75.2%?3 (804) an acute problem and 11.6%?2 (124) the worsening of a chronic problem. The beginning of the symptoms started in 53.7%?3 (573) of the cases a few hours earlier.87.4%?2 (933) of the patients present unchanged vital signs. there was no need for a diagnostic test in 29.4%?3 (314) of the cases nor a pathological test in 56.9%?3 (608). In 58.7%?3 (627) there was no need to start a treatment in HIS.More than half (59,3% ?3) of the urgencies were seen by a mir-i (doctor trainee) by themselves 26,9%?3 (287), or supervised 32,4% ?3 (346). 79,7%?2 (851) of the emergencies were taken care of in the Clinical Hospital at the doctor's office 53,6%?3 (573). 41%?3 (438) of the urgencies were taken care of in the evening, 39,5%?3 (422) in the morning and 19%?2 (203) at night; busiest times were from 8-12h (20,7% ?2), 15-18h (19,8%?2), 12-15h (16,4% ?2) and 18-20h (11,8% ?2). The differences in the days of the week were minimum: Monday-164, Thursday-163 and Tuesday and Wednesday-154. The differences between months were also small, August, May and JulY-100.Most of the urgencies ended with a discharge 82,1%?2 (877), being the diagnosis to the discharge in 90%?2 (961) of the cases a diagnosis CIE, mainly, traumatisms and poisoning.The visits according to PAUHm, were appropriated in 70,8%? (756) of the cases and inappropriated 28,2%?3 (301). The intensity criteria diagnostic, turned out to be the most important 65,2%?3 (696).The multi-variant study showed as independent variables associated to a greater risk of inadequacy of the visit, according to the PAUHm: referred on their own initiative , absence of diagnosis CIE, absence of personal antecedents and consultation for non-acute problems.
