Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769 |
Resumo: | Introduction: Frequent users contribute to an excessive volume of admissions in the emergency department, impairing the quality of healthcare services. The aim of this study was to identify and characterize the population of frequent users of the pediatric emergencydepartment, establish an individual plan of intervention and evaluate its efficacy.Material and Methods: Intervention study including children and adolescents younger than 16 years, with more than 10 visits in a year to an emergency department of a secondary care hospital. An intervention program was created with a multidisciplinary team and a case manager, who was responsible for the execution of the individual plan of intervention. One year later, the number of visits after the intervention was assessed.Results: We identified 90 patients with a frequent user profile, with 1182 visits. Only 17.3% of the visits had a previous referral. Most of the visits were considered non urgent/less urgent (59%). The intervention included 82 children/adolescents. One year later, there was a significant reduction in the number of visits: median reduction of 62% in 78 participants.Discussion: Most of the visits by frequent users were considered non urgent/less urgent, reflecting a clinically unjustified use of the emergency department. The intervention seems to be effective as the number of visits decreased.Conclusion: This population of frequent users seems to be a heterogeneous group with different problems and levels of complexity. A multidisciplinary and individual intervention, with a case manager, might contribute to reduce the excessive use of the emergency department and improve the provision of health care services to these children. |
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Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot StudyUtilizadores Frequentes da Urgência Pediátrica: Conhecer, Intervir e Analisar - Um Estudo PilotoEmergency ServiceHospitalHealth Services MisusePediatricsPortugalMau Uso de Serviços de SaúdePediatriaPortugalServiço de Urgência HospitalarIntroduction: Frequent users contribute to an excessive volume of admissions in the emergency department, impairing the quality of healthcare services. The aim of this study was to identify and characterize the population of frequent users of the pediatric emergencydepartment, establish an individual plan of intervention and evaluate its efficacy.Material and Methods: Intervention study including children and adolescents younger than 16 years, with more than 10 visits in a year to an emergency department of a secondary care hospital. An intervention program was created with a multidisciplinary team and a case manager, who was responsible for the execution of the individual plan of intervention. One year later, the number of visits after the intervention was assessed.Results: We identified 90 patients with a frequent user profile, with 1182 visits. Only 17.3% of the visits had a previous referral. Most of the visits were considered non urgent/less urgent (59%). The intervention included 82 children/adolescents. One year later, there was a significant reduction in the number of visits: median reduction of 62% in 78 participants.Discussion: Most of the visits by frequent users were considered non urgent/less urgent, reflecting a clinically unjustified use of the emergency department. The intervention seems to be effective as the number of visits decreased.Conclusion: This population of frequent users seems to be a heterogeneous group with different problems and levels of complexity. A multidisciplinary and individual intervention, with a case manager, might contribute to reduce the excessive use of the emergency department and improve the provision of health care services to these children.Introdução: Os utilizadores frequentes contribuem para um volume excessivo de admissões no serviço de urgência, prejudicando a qualidade dos serviços prestados. O objetivo deste estudo foi identificar e caracterizar os utilizadores frequentes da urgência pediátrica, traçar um plano de intervenção e avaliar a sua eficácia.Material e Métodos: Estudo de intervenção, incluindo crianças e adolescentes menores de 16 anos, com mais de 10 admissões num ano na urgência pediátrica de um hospital de nível II. Foi criado um modelo de intervenção com uma equipa multidisciplinar e um gestor de caso, responsável pela execução do plano de intervenção individualizado. Após um ano de intervenção foi avaliada a evolução do número de admissões.Resultados: Identificámos 90 utentes com o perfil de utilizador frequente, com 1182 admissões. Apenas 17,3% das admissões eram referenciadas. A maioria das admissões foi considerada não urgente/pouco urgente (59%). Foram incluídas na intervenção 82 crianças/adolescentes. Após um ano de intervenção verificou-se uma diminuição significativa do número de admissões, com uma redução média de 62% em 78 participantes.Discussão: A maioria das admissões dos utilizadores frequentes foi considerada não urgente/pouco urgente, evidenciando a ausência de indicação clínica para observação hospitalar. Os resultados da intervenção parecem ser favoráveis, com uma redução do número de admissões.Conclusão: Esta população de utilizadores frequentes da urgência pediátrica constitui um grupo heterogéneo, com problemas de complexidade variável. Um modelo de intervenção multidisciplinar e individualizado, com um gestor de caso pode contribuir para reduzir o recurso excessivo à urgência e melhorar a prestação de cuidados de saúde a estas crianças.Ordem dos Médicos2020-05-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/x-ms-bmpimage/x-ms-bmpimage/x-ms-bmpapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769oai:ojs.www.actamedicaportuguesa.com:article/12769Acta Médica Portuguesa; Vol. 33 No. 5 (2020): May; 311-317Acta Médica Portuguesa; Vol. 33 N.º 5 (2020): Maio; 311-3171646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/5936https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11823https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11824https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11825https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11826https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11827https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11926https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11927https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11928https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11929https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/12013Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessMartins, MartaMarques, RitaSousa, MarinaValério, AnaCabral, IsadoraAlmeida, Filomena2022-12-20T11:06:42Zoai:ojs.www.actamedicaportuguesa.com:article/12769Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:14.011872Repositório 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 |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study Utilizadores Frequentes da Urgência Pediátrica: Conhecer, Intervir e Analisar - Um Estudo Piloto |
title |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study |
spellingShingle |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study Martins, Marta Emergency Service Hospital Health Services Misuse Pediatrics Portugal Mau Uso de Serviços de Saúde Pediatria Portugal Serviço de Urgência Hospitalar |
title_short |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study |
title_full |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study |
title_fullStr |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study |
title_full_unstemmed |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study |
title_sort |
Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study |
author |
Martins, Marta |
author_facet |
Martins, Marta Marques, Rita Sousa, Marina Valério, Ana Cabral, Isadora Almeida, Filomena |
author_role |
author |
author2 |
Marques, Rita Sousa, Marina Valério, Ana Cabral, Isadora Almeida, Filomena |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Martins, Marta Marques, Rita Sousa, Marina Valério, Ana Cabral, Isadora Almeida, Filomena |
dc.subject.por.fl_str_mv |
Emergency Service Hospital Health Services Misuse Pediatrics Portugal Mau Uso de Serviços de Saúde Pediatria Portugal Serviço de Urgência Hospitalar |
topic |
Emergency Service Hospital Health Services Misuse Pediatrics Portugal Mau Uso de Serviços de Saúde Pediatria Portugal Serviço de Urgência Hospitalar |
description |
Introduction: Frequent users contribute to an excessive volume of admissions in the emergency department, impairing the quality of healthcare services. The aim of this study was to identify and characterize the population of frequent users of the pediatric emergencydepartment, establish an individual plan of intervention and evaluate its efficacy.Material and Methods: Intervention study including children and adolescents younger than 16 years, with more than 10 visits in a year to an emergency department of a secondary care hospital. An intervention program was created with a multidisciplinary team and a case manager, who was responsible for the execution of the individual plan of intervention. One year later, the number of visits after the intervention was assessed.Results: We identified 90 patients with a frequent user profile, with 1182 visits. Only 17.3% of the visits had a previous referral. Most of the visits were considered non urgent/less urgent (59%). The intervention included 82 children/adolescents. One year later, there was a significant reduction in the number of visits: median reduction of 62% in 78 participants.Discussion: Most of the visits by frequent users were considered non urgent/less urgent, reflecting a clinically unjustified use of the emergency department. The intervention seems to be effective as the number of visits decreased.Conclusion: This population of frequent users seems to be a heterogeneous group with different problems and levels of complexity. A multidisciplinary and individual intervention, with a case manager, might contribute to reduce the excessive use of the emergency department and improve the provision of health care services to these children. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-05-04 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769 oai:ojs.www.actamedicaportuguesa.com:article/12769 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769 |
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oai:ojs.www.actamedicaportuguesa.com:article/12769 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/5936 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11823 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11824 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11825 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11826 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11827 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11926 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11927 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11928 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/11929 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12769/12013 |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 33 No. 5 (2020): May; 311-317 Acta Médica Portuguesa; Vol. 33 N.º 5 (2020): Maio; 311-317 1646-0758 0870-399X 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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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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