Revista Clínica de Medicina de Familia
Print version ISSN 1699-695X
REINOSO HERMIDA, Santiago et al. Means of access to hospital emergency departments and relevance of the consultation. Rev Clin Med Fam [online]. 2011, vol.4, n.3, pp.205-210. ISSN 1699-695X. http://dx.doi.org/10.4321/S1699-695X2011000300004.
Objective. To determine the different means of access to hospital emergency departments (ED), assess the appropriateness of consultations given there and analyze the possible association between access and appropriateness as well as other related factors. Design. Observational cross-sectional study. Setting. Hospital Emergency Departments. Participants. Patients who go to the ED on their own accord or are referred by Prehospital Emergency Care (PEC) services or a General Practitioner (GP). No-one refused to answer the questionnaire. Measurements. Ad hoc questionnaire with 14 variables: socio-demographic and others related with the means of access and type of consultation in the ED. The survey was conducted in the ED by the researchers who provided care to all patients seen by them on each shift. Results. A total of 264 surveys were analyzed. 77.6% (205) of cases were due to acute episodes of disease onset and trauma related events. At total of 74 (28.0%) patients had previously consulted their GP for the same reason. For 68.4% of the patients referred by their GP and 25% of the patients who came on their own accord the consultation in the ED was appropriate. There were no differences in the percentage of patients whose emergency consultation was not appropriate. Patients who came to ED on their own accord were younger (mean difference 9.2 years, 95% CI: 3.4-14.9, p = 0.001) and mostly came from urban areas (x2 = 9.8, p = 0.002). Conclusions. Most patients requiring emergency care access the ED through the PEC service, this is influenced by the urban origin, younger age and the existence of previous admissions. Referrals by PEC or GP improves the appropriateness of the consultations in the ED.
Keywords : Attitude to Health; Emergency Medical Services; Rural Health.