Utilization of the pediatric emergency department: the experience of a Portuguese center
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Scientia Medica (Porto Alegre. Online) |
Texto Completo: | https://revistaseletronicas.pucrs.br/scientiamedica/article/view/24919 |
Resumo: | DOI: 10.15448/1980-6108.2017.1.24919Aims: The excess demand for pediatric emergency services has caused much concern among health professionals and hospital administrators. The aim of this study was to assess the utilization of a pediatric emergency department and to determine whether its use was injudicious. Methods: Retrospective cross-sectional analysis of all emergency cases treated throughout 2012 in a general hospital located in the metropolitan area of Lisbon, Portugal. The data were obtained from the hospital’s computer information system. Each patient was submitted at admission to the Manchester triage system adapted for Portugal, and the episodes were categorized into immediate, very urgent, urgent, standard, non-urgent, and not classified. All those episodes classified as standard and non-urgent were denoted as unjustified urgent episodes. The data were collected anonymously and analyzed by the IBM SPSS Statistics software using the chi-square test and one-way ANOVA at a 5% significance level (p<0.05).Results: We analyzed 37,099 pediatric emergency department episodes, of which 19,478 patients were male (53%), the median age was 4 years (interquartile range of 1-9 years), and 78.4% were up to 10 years old. Of all the episodes, 21,177 (57.1%) were classified as standard and 15,470 (41.6%) as urgent or very urgent. Of these patients, 27,294 (73.6%) used the emergency department during the week and 28,679 (77.3%) between 10 a.m. and 12 a.m. It was found that in 90.8% of very urgent, 97.1% of urgent, and 99.4% of standard episodes, patients were discharged without the need for hospitalization. Conclusions: More than half of the children who used the pediatric emergency department had standard or non-urgent needs, and almost all of them were discharged with follow-up recommendations by the attending physician. Most of the episodes occurred during opening hours of primary healthcare centers. |
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Utilization of the pediatric emergency department: the experience of a Portuguese centerUtilização do serviço de urgência pediátrica: a experiência de um centro portuguêsemergency medicineemergency health servicespediatricsoverutilization of health services.medicina de urgênciaserviços médicos de emergênciapediatriauso excessivo de produtos e serviços de saúde.DOI: 10.15448/1980-6108.2017.1.24919Aims: The excess demand for pediatric emergency services has caused much concern among health professionals and hospital administrators. The aim of this study was to assess the utilization of a pediatric emergency department and to determine whether its use was injudicious. Methods: Retrospective cross-sectional analysis of all emergency cases treated throughout 2012 in a general hospital located in the metropolitan area of Lisbon, Portugal. The data were obtained from the hospital’s computer information system. Each patient was submitted at admission to the Manchester triage system adapted for Portugal, and the episodes were categorized into immediate, very urgent, urgent, standard, non-urgent, and not classified. All those episodes classified as standard and non-urgent were denoted as unjustified urgent episodes. The data were collected anonymously and analyzed by the IBM SPSS Statistics software using the chi-square test and one-way ANOVA at a 5% significance level (p<0.05).Results: We analyzed 37,099 pediatric emergency department episodes, of which 19,478 patients were male (53%), the median age was 4 years (interquartile range of 1-9 years), and 78.4% were up to 10 years old. Of all the episodes, 21,177 (57.1%) were classified as standard and 15,470 (41.6%) as urgent or very urgent. Of these patients, 27,294 (73.6%) used the emergency department during the week and 28,679 (77.3%) between 10 a.m. and 12 a.m. It was found that in 90.8% of very urgent, 97.1% of urgent, and 99.4% of standard episodes, patients were discharged without the need for hospitalization. Conclusions: More than half of the children who used the pediatric emergency department had standard or non-urgent needs, and almost all of them were discharged with follow-up recommendations by the attending physician. Most of the episodes occurred during opening hours of primary healthcare centers.DOI: 10.15448/1980-6108.2017.1.24919Objetivos: A elevada afluência aos serviços de urgência pediátrica tem gerado muita preocupação entre profissionais de saúde e administradores hospitalares. O objetivo deste estudo foi compreender as características da afluência a um serviço de urgência pediátrica e verificar se existe utilização injustificada do mesmo.Métodos: Realizou-se um estudo retrospectivo no qual foram analisados todos os episódios de urgência pediátrica ocorridos durante o ano de 2012 em um hospital distrital da área metropolitana de Lisboa, Portugal. Os dados foram obtidos pelo serviço de informática do hospital, já estando os episódios classificados segundo o sistema de triagem de Manchester adaptado para Portugal – emergente, muito urgente, urgente, pouco urgente, não urgente e não classificável, o qual é atribuído a cada doente no momento de entrada no serviço de urgência pediátrica. Definiu-se como episódio de urgência não justificado todos aqueles classificados como pouco urgentes e não urgentes. Os dados foram trabalhados de forma totalmente anônima, por meio do programa IBM SPSS Statistics e utilizando os testes estatísticos qui-quadrado e ANOVA one-way, com nível de significância de 5% (p<0,05). Resultados: Foi analisada uma amostra de 37.099 episódios de atendimento no serviço de urgência pediátrica, dos quais 19.478 (53%) corresponderam a indivíduos do sexo masculino. A mediana de idade foi 4 anos (intervalo interquartil 1-9) e 78,4% tinham até 10 anos. De todos os episódios, 98,8% foram classificados entre três categorias: muito urgentes, urgentes e pouco urgentes, sendo 15.470 (41,7%) urgentes ou muito urgentes e 21.177 (57,1%) pouco urgentes. Destes pacientes, 27.294 (73,6%) recorreram ao serviço de urgência durante a semana e 28.679 (77,3%) entre as 10 e as 24 horas. Verificou-se que em 90,8% dos episódios muito urgentes, 97,1% dos urgentes e 99,4% dos pouco urgentes os pacientes tiveram alta sem necessitar de hospitalização. Conclusões: Mais de metade das crianças que utilizaram o serviço de urgência pediátrica do hospital em estudo apresentavam situações pouco urgentes e praticamente todas essas tiveram alta para o domicílio, com indicação para seguimento pelo médico assistente. Grande parte dos atendimentos ocorreu durante o horário de funcionamento dos centros de saúde.Editora da PUCRS - ediPUCRS2017-01-25info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/2491910.15448/1980-6108.2017.1.24919Scientia Medica; Vol. 27 No. 1 (2017); ID24919Scientia Medica; v. 27 n. 1 (2017); ID249191980-61081806-556210.15448/1980-6108.2017.1reponame:Scientia Medica (Porto Alegre. Online)instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSporhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/24919/15381Copyright (c) 2017 Scientia Medicainfo:eu-repo/semantics/openAccessRafael, Margarida S.Portela, SofiaSousa, PauloFernandes, Adalberto Campos2017-08-03T17:07:23Zoai:ojs.revistaseletronicas.pucrs.br:article/24919Revistahttps://revistaseletronicas.pucrs.br/scientiamedica/PUBhttps://revistaseletronicas.pucrs.br/scientiamedica/oaiscientiamedica@pucrs.br || editora.periodicos@pucrs.br1980-61081806-5562opendoar:2017-08-03T17:07:23Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.none.fl_str_mv |
Utilization of the pediatric emergency department: the experience of a Portuguese center Utilização do serviço de urgência pediátrica: a experiência de um centro português |
title |
Utilization of the pediatric emergency department: the experience of a Portuguese center |
spellingShingle |
Utilization of the pediatric emergency department: the experience of a Portuguese center Rafael, Margarida S. emergency medicine emergency health services pediatrics overutilization of health services. medicina de urgência serviços médicos de emergência pediatria uso excessivo de produtos e serviços de saúde. |
title_short |
Utilization of the pediatric emergency department: the experience of a Portuguese center |
title_full |
Utilization of the pediatric emergency department: the experience of a Portuguese center |
title_fullStr |
Utilization of the pediatric emergency department: the experience of a Portuguese center |
title_full_unstemmed |
Utilization of the pediatric emergency department: the experience of a Portuguese center |
title_sort |
Utilization of the pediatric emergency department: the experience of a Portuguese center |
author |
Rafael, Margarida S. |
author_facet |
Rafael, Margarida S. Portela, Sofia Sousa, Paulo Fernandes, Adalberto Campos |
author_role |
author |
author2 |
Portela, Sofia Sousa, Paulo Fernandes, Adalberto Campos |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Rafael, Margarida S. Portela, Sofia Sousa, Paulo Fernandes, Adalberto Campos |
dc.subject.por.fl_str_mv |
emergency medicine emergency health services pediatrics overutilization of health services. medicina de urgência serviços médicos de emergência pediatria uso excessivo de produtos e serviços de saúde. |
topic |
emergency medicine emergency health services pediatrics overutilization of health services. medicina de urgência serviços médicos de emergência pediatria uso excessivo de produtos e serviços de saúde. |
description |
DOI: 10.15448/1980-6108.2017.1.24919Aims: The excess demand for pediatric emergency services has caused much concern among health professionals and hospital administrators. The aim of this study was to assess the utilization of a pediatric emergency department and to determine whether its use was injudicious. Methods: Retrospective cross-sectional analysis of all emergency cases treated throughout 2012 in a general hospital located in the metropolitan area of Lisbon, Portugal. The data were obtained from the hospital’s computer information system. Each patient was submitted at admission to the Manchester triage system adapted for Portugal, and the episodes were categorized into immediate, very urgent, urgent, standard, non-urgent, and not classified. All those episodes classified as standard and non-urgent were denoted as unjustified urgent episodes. The data were collected anonymously and analyzed by the IBM SPSS Statistics software using the chi-square test and one-way ANOVA at a 5% significance level (p<0.05).Results: We analyzed 37,099 pediatric emergency department episodes, of which 19,478 patients were male (53%), the median age was 4 years (interquartile range of 1-9 years), and 78.4% were up to 10 years old. Of all the episodes, 21,177 (57.1%) were classified as standard and 15,470 (41.6%) as urgent or very urgent. Of these patients, 27,294 (73.6%) used the emergency department during the week and 28,679 (77.3%) between 10 a.m. and 12 a.m. It was found that in 90.8% of very urgent, 97.1% of urgent, and 99.4% of standard episodes, patients were discharged without the need for hospitalization. Conclusions: More than half of the children who used the pediatric emergency department had standard or non-urgent needs, and almost all of them were discharged with follow-up recommendations by the attending physician. Most of the episodes occurred during opening hours of primary healthcare centers. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-01-25 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/24919 10.15448/1980-6108.2017.1.24919 |
url |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/24919 |
identifier_str_mv |
10.15448/1980-6108.2017.1.24919 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/24919/15381 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Scientia Medica info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Scientia Medica |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
dc.source.none.fl_str_mv |
Scientia Medica; Vol. 27 No. 1 (2017); ID24919 Scientia Medica; v. 27 n. 1 (2017); ID24919 1980-6108 1806-5562 10.15448/1980-6108.2017.1 reponame:Scientia Medica (Porto Alegre. Online) instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) instacron:PUC_RS |
instname_str |
Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
instacron_str |
PUC_RS |
institution |
PUC_RS |
reponame_str |
Scientia Medica (Porto Alegre. Online) |
collection |
Scientia Medica (Porto Alegre. Online) |
repository.name.fl_str_mv |
Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
repository.mail.fl_str_mv |
scientiamedica@pucrs.br || editora.periodicos@pucrs.br |
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1809101751255564288 |