[Appropriateness of the utilization of an emergency department]

Med Clin (Barc). 2004 Nov 6;123(16):615-8. doi: 10.1016/s0025-7753(04)74618-7.
[Article in Spanish]

Abstract

Background and objective: The increase in the demand of clinical attention in emergency departments justifies the need to evaluate its adequacy to the population health needs requiring emergency attention. The objective of this study is to evaluate the adequacy of patients' visits to the emergency departments of a third level hospital.

Material and method: Descriptive study with analytic components. Random sample: 499 medical reports of patients treated in the Emergency Department. The HUAP (Appropriateness Hospital Emergencies Protocol) protocol was applied. We carried out a descriptive analysis of the sample, a relation analysis and finally we carried out a multiple logistic regression analysis.

Results: 30.7% visits were inadequate. The higher percentage of inappropriateness was found in subjects younger than 40 years (44%); in those without chronic pathology (53.3%) and in those who came spontaneously (88.4%). Half of the appropriate visits owed, exclusively, to achieving "diagnostic tests" criteria.

Conclusions: The Appropriateness Hospital Emergencies Protocol allowed to identify two population groups. It is necessary to implement strategies to change the health services offer, adapted to the differences found and taking into account the increase in the appropriate demand.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Health Services Misuse / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Spain
  • Utilization Review / methods