Abstract

GUILLEN-ASTETE, Carlos; HERNANDEZ-EGIDO, María  and  CARBALLO-CARDONA, César. Adequacy of hospital admissions according to the type of physician who performs the indication for admission to an emergency room with a model of non-pyramidal supervision. FEM (Ed. impresa) [online]. 2015, vol.18, n.6, pp.405-409. ISSN 2014-9840.  https://dx.doi.org/10.4321/S2014-98322015000700008.

Introduction. A hospital admission adequacy warrants sustainability of a healthcare system and contributes increasing patients' safety. Teaching hospitals must assure that pedagogic exercise with residents do not affect the adequacy of hospital admissions. Aim. To determine if our resident supervision model, known as non-pyramidal, warrants and homogeneous proportion of hospital admissions from the emergency department with independence of the different kind of physician who performs the instruction of hospital admission. Subjects and methods. A validated international protocol of hospital admission adequacy was applied to a randomized group of registries of hospital admissions which was used in a study of prevalence of adequate hospital admissions performed previously. The proportion of adequate hospital admission was compared according to who was who ordered the admission: a urgency physician staff, a first year resident under staff supervision and a second or third year resident. Results. The hospital admissions from the emergency department ordered by a staff physician, a first year resident and a second or third year resident were 125, 93 and 78 respectively. In those three groups, hospital admissions considered inadequate were 4 (3.2%), 5 (5.4%) and 4 (5.1%), respectively. There was no statistically significant difference among those proportions. Conclusions. In all groups, proportion of inadequate hospital admissions was less than those found in national reports. We believe that our non-pyramidal supervision model assures sustainability of the healthcare system saving costs of inadequate hospital admissions and contributes to warrant patients' safety.

Keywords : Emergency supervision; Hospital admission adequacy; Postgraduate medical formation.

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