Discharge against medical advice from emergency department
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.56732/pensarenf.v25i2.186 |
Resumo: | Introduction: The prevalence of discharge against medical advice from the emergency department is a clinical indicator of quality management and its study is therefore relevant. The aim of this research was to assess the profile of clients leaving the emergency department. Methods: Quantitative Analysis and retrospective cohort study. All clients who left the emergency department of a central hospital in central Portugal in 2018 were included. The data was collected on the basis of administrative information, with registration on a specific clinical data collection table. Results: In 2018, 85596 patients came to the emergency service, with a abandonment rate of 3.04% (n=2599). Of the total sample, 1315 patients (50.6%) were male and 1284 (49.4%) female. The average age of customers is 48.21 years old and 46.4% are in the 36-65 age group. The months in which there were the most abandonment records were August (n=11.6%) and February (n=10.4%), and it was during the morning that there were the most abandonment episodes (51.3%). The patients with the clinical priority classified as urgent were those with the highest prevalence of abandonment (39.6%). The clinical priority of non-urgent patients shows 37.9% of abandonments. The majority of patients who left the emergency service after being evaluated by medical screening (78.7%). Conclusion: The profile of the patients leaving the emergency service is predominantly female, aged 35-65 (with an average age of 48.21), most of whom already have a defined clinical priority and are classified as urgent (yellow). The resolution of this problem should be assumed as a priority by the regulatory authorities, in order to optimize the quality of care and reduce the direct and indirect impact on patients who leave the services. |
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Discharge against medical advice from emergency departmentAlta contra parecer médico no serviço de urgênciaPatient DischargeEmergency Service HospitalQuality IndicatorsHealth CareAlta do PacienteServiço Hospitalar de EmergênciaIndicadores de Qualidade em Assistência à SaúdeIntroduction: The prevalence of discharge against medical advice from the emergency department is a clinical indicator of quality management and its study is therefore relevant. The aim of this research was to assess the profile of clients leaving the emergency department. Methods: Quantitative Analysis and retrospective cohort study. All clients who left the emergency department of a central hospital in central Portugal in 2018 were included. The data was collected on the basis of administrative information, with registration on a specific clinical data collection table. Results: In 2018, 85596 patients came to the emergency service, with a abandonment rate of 3.04% (n=2599). Of the total sample, 1315 patients (50.6%) were male and 1284 (49.4%) female. The average age of customers is 48.21 years old and 46.4% are in the 36-65 age group. The months in which there were the most abandonment records were August (n=11.6%) and February (n=10.4%), and it was during the morning that there were the most abandonment episodes (51.3%). The patients with the clinical priority classified as urgent were those with the highest prevalence of abandonment (39.6%). The clinical priority of non-urgent patients shows 37.9% of abandonments. The majority of patients who left the emergency service after being evaluated by medical screening (78.7%). Conclusion: The profile of the patients leaving the emergency service is predominantly female, aged 35-65 (with an average age of 48.21), most of whom already have a defined clinical priority and are classified as urgent (yellow). The resolution of this problem should be assumed as a priority by the regulatory authorities, in order to optimize the quality of care and reduce the direct and indirect impact on patients who leave the services.Introdução: A prevalência de abandono do serviço de urgência constitui um indicador clínico de gestão da qualidade, pelo que o seu estudo se assume como pertinente. O objetivo da presente investigação foi avaliar o perfil dos clientes que abandonam o serviço de urgência. Métodos: Estudo de análise quantitativa e de coorte retrospetivo. Foram incluídos todos os clientes que que abandonaram o serviço de urgência de um hospital central no centro de Portugal em 2018. Os dados foram recolhidos com base na informação administrativa, com registo numa grelha clínica ad hoc para recolha de dados. Resultados: No ano de 2018 acorreram ao serviço de urgência objeto do presente estudo, 85596 clientes, tendo-se verificado uma taxa de abandono de 3,04% (n=2599). Do total da amostra, observou-se que 1315 clientes (50,6%) são do género masculino e 1284 (49,4%) são do género feminino. A idade média dos clientes é 48,21 anos e 46,4% encontra-se na faixa etária dos 36-65 anos. Os meses em que houve mais registos de abandono do serviço de urgência foram agosto (n=11,6%) e fevereiro (n=10,4%), e foi durante o período da manhã que se registaram mais episódios de abandono (51,3%). Os clientes com a prioridade clínica classificada de urgente foram os que apresentam uma maior prevalência de abandono (39,6%). A prioridade clínica de pouco urgente apresenta 37,9% de abandonos. A maioria dos clientes que abandonou o serviço de urgência após ser avaliado pela triagem médica (78,7%). Conclusão: O perfil do cliente que abandona o Serviço de urgência é predominantemente do sexo feminino, na faixa etária dos 35-65 anos (com uma média de idades de 48,21 anos), na sua maioria já com prioridade clínica definida e classificada como urgente (amarela). A resolução desta problemática deve ser assumida como uma prioridade pelas entidades reguladoras, para otimizar a qualidade dos cuidados e diminuir o impacto direto e indireto nos clientes que abandonam os serviços.Escola Superior de Enfermagem de Lisboa - ESEL/ CIDNUR2022-04-20info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.56732/pensarenf.v25i2.186https://doi.org/10.56732/pensarenf.v25i2.186Pensar Enfermagem ; Vol. 25 No. 2 (2021): Journal of Nursing Pensar Enfermagem; 65-76Pensar Enfermagem ; Vol. 25 N.º 2 (2021): Revista Científica Pensar Enfermagem; 65-761647-55260873-890410.56732/pensarenf.v25i2reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://pensarenfermagem.esel.pt/index.php/esel/article/view/186https://pensarenfermagem.esel.pt/index.php/esel/article/view/186/192Bernardete, PaulaCunha, MadalenaVicente, Ana RitaMota, Mauroinfo:eu-repo/semantics/openAccess2023-09-26T10:38:09Zoai:pensarenfermagem.esel.pt:article/186Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:31:14.795927Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Discharge against medical advice from emergency department Alta contra parecer médico no serviço de urgência |
title |
Discharge against medical advice from emergency department |
spellingShingle |
Discharge against medical advice from emergency department Bernardete, Paula Patient Discharge Emergency Service Hospital Quality Indicators Health Care Alta do Paciente Serviço Hospitalar de Emergência Indicadores de Qualidade em Assistência à Saúde |
title_short |
Discharge against medical advice from emergency department |
title_full |
Discharge against medical advice from emergency department |
title_fullStr |
Discharge against medical advice from emergency department |
title_full_unstemmed |
Discharge against medical advice from emergency department |
title_sort |
Discharge against medical advice from emergency department |
author |
Bernardete, Paula |
author_facet |
Bernardete, Paula Cunha, Madalena Vicente, Ana Rita Mota, Mauro |
author_role |
author |
author2 |
Cunha, Madalena Vicente, Ana Rita Mota, Mauro |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Bernardete, Paula Cunha, Madalena Vicente, Ana Rita Mota, Mauro |
dc.subject.por.fl_str_mv |
Patient Discharge Emergency Service Hospital Quality Indicators Health Care Alta do Paciente Serviço Hospitalar de Emergência Indicadores de Qualidade em Assistência à Saúde |
topic |
Patient Discharge Emergency Service Hospital Quality Indicators Health Care Alta do Paciente Serviço Hospitalar de Emergência Indicadores de Qualidade em Assistência à Saúde |
description |
Introduction: The prevalence of discharge against medical advice from the emergency department is a clinical indicator of quality management and its study is therefore relevant. The aim of this research was to assess the profile of clients leaving the emergency department. Methods: Quantitative Analysis and retrospective cohort study. All clients who left the emergency department of a central hospital in central Portugal in 2018 were included. The data was collected on the basis of administrative information, with registration on a specific clinical data collection table. Results: In 2018, 85596 patients came to the emergency service, with a abandonment rate of 3.04% (n=2599). Of the total sample, 1315 patients (50.6%) were male and 1284 (49.4%) female. The average age of customers is 48.21 years old and 46.4% are in the 36-65 age group. The months in which there were the most abandonment records were August (n=11.6%) and February (n=10.4%), and it was during the morning that there were the most abandonment episodes (51.3%). The patients with the clinical priority classified as urgent were those with the highest prevalence of abandonment (39.6%). The clinical priority of non-urgent patients shows 37.9% of abandonments. The majority of patients who left the emergency service after being evaluated by medical screening (78.7%). Conclusion: The profile of the patients leaving the emergency service is predominantly female, aged 35-65 (with an average age of 48.21), most of whom already have a defined clinical priority and are classified as urgent (yellow). The resolution of this problem should be assumed as a priority by the regulatory authorities, in order to optimize the quality of care and reduce the direct and indirect impact on patients who leave the services. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-04-20 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.56732/pensarenf.v25i2.186 https://doi.org/10.56732/pensarenf.v25i2.186 |
url |
https://doi.org/10.56732/pensarenf.v25i2.186 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://pensarenfermagem.esel.pt/index.php/esel/article/view/186 https://pensarenfermagem.esel.pt/index.php/esel/article/view/186/192 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Escola Superior de Enfermagem de Lisboa - ESEL/ CIDNUR |
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Escola Superior de Enfermagem de Lisboa - ESEL/ CIDNUR |
dc.source.none.fl_str_mv |
Pensar Enfermagem ; Vol. 25 No. 2 (2021): Journal of Nursing Pensar Enfermagem; 65-76 Pensar Enfermagem ; Vol. 25 N.º 2 (2021): Revista Científica Pensar Enfermagem; 65-76 1647-5526 0873-8904 10.56732/pensarenf.v25i2 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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