Loría CJ, Solares GJL

Language: Spanish
References: 28
Page: 251-258
PDF size: 191.57 Kb.

ABSTRACT

Introduction: Overcapacity of the Emergency Room is considered among negative factors that influence care in the Emergency Room at hospitals of the Mexican Institute of Social Security (IMSS). Among principal causes are admission of non-Social Security patients. Objective: Our objective was to determine number, characteristics, and procedures that derive from care of non-Social Security patients at Regional Hospital 25 TSU. The study design was descriptive and transversal. Method and materials: We carried out data collection of all non-Social Security patients seen at TSU of Regional Hospital 25, establishing general characteristics, more frequent pathol-ogies, days in hospital, mortality, and procedures in this population; later, we did descriptive statistic analysis. Results: During the analysis of the sixth month, we found a total of 958 admissions of non-Social Security patients, which corresponded to 35.2 % of total admissions. The predominant sex was male at a relation of 2.2:1. Most frequent ages were 26-35 and 66-75 years of age. The shift with greatest demand was the morning shift. Only 41 patients (4.2 %) were considered urgent. Most patients were checked in for 12 h at the TSU (98 %). Trauma causes comprised greatest incidence of admission (33.7 %). A total of 3926 procedures were carried out. A total of 6333 interconsultations were carried out, the most frequent at the intensive care unit. 66 % of the patients were sent to the observation room, only 5 % of patients were admitted to non-IMSS hospitals. Conclusions: The number of non-Social Security patients admitted at the TSU is elevated, as are resources used for them. Many of these patients are real emergencies, the reason for admitting them. This kind of the overuse of the TSU implies increased use of resources. This resource is not contemplated by annual programs, probably deriving in negative attention with IMSS Social Security patients. It will be necessary to assignate resources and polices that are adequate at the IMSS, such as for emergencies to avoid greater drain of funds.

REFERENCES

1. 1. Clancy C, Eisenberg J. Emergency medicine in population-based systems of care. Ann Emerg Med 1997;30:801-803.

2. 2. McCabe JB. Emergency medicine and the Aca-demic Health Center. Ann Emerg Med 1997; 30: 773-777.

3. 3. Williams RM. The costs of visits to emergency departments. N Engl J Med 1996;334:642-646.

4. 4. Spaite DCE, Valenzuela TD, Meislein HW. Devel-oping a foundation for the evaluation of expanded-scope EMS: A window of opportunity that cannot be ignored. Ann Emerg Med. 1997;30:791-796.

5. 5. Osterwalder J. Emergency medicine in Swit-zerland. Ann Emerg Med 1998;32:243-247.

6. 6. Partridge RA. Emergency medicine in West Kazakh-stan. Ann Emerg Med 1998;32:493-497.

7. 7. Nikkanen-Heikki E, Lenworth M, Pouges C. Emer-gency medicine in France. Ann Emerg Med 1998; 31:116-120.

8. 8. Lasseter JA, Pyles JR, Galijasevic S. Emergency medicine in Bosnia and Herzagovina. Ann Emerg Med 1997;30:527-529.

9. 9. Moecke H. Emergency medicine in Germany. Ann Emerg Med 1998;31:111-115.

10. Repetto C, Casagranda I, Overton D, Gai V. Emer-gency medicine: The Italian experience. Ann Emerg Med 1998;32:248:93-97.

11. Townes DA, Lee-Thomas E, Sergei G, Van-Rooyen M. Emergency medicine in Russia. Ann Emerg Med 1998;32:239-242.

12. Lloyd S, Streiner D, Shannon S. Demographic characteristics of full-time emergency physicians in Canada. Am J Emerg Med 1993;11:364-370.

13. Posaw LL, Aggarwal PLB, Bernstein SL. Emer-gency medicine in the New Delhi Area India. Ann Emerg Med 1998;32:609-615.

14. Arnold JL, Song-Hwa S, Chung-Jae M. The recent development of emergency medicine in South Korea. Ann Emerg Med 1998;32:730-735.

15. Alagappan K, Cherukuri K, Norang V. Early deve-lopment of emergency medicine in Chenmai (Madras) India. Ann Emerg Med 1998;32:604-608.

16. Church AL, Plitponkamin A. Emergency medicine in Thailand. Ann Emerg Med 1998;32:93-97.

17. Weil TP. Universal access: Its potential impact on emergency medicine. Ann Emerg Med 1992; 21(10):1236-1240. (Editorial, comment.)

18. Larkin GL, Adams JG, Derse AR, Iserson KV, Gotthold WE. Managed care ethics: An emergency? Ann Emerg Med 1996;28(6):683-689.

19. Young GP, Sklar D. Health care reform and emer-gency medicine Ann Emerg Med 1995;25(5):666-674.

20. Informe de la Reunión de Expertos en Políticas de Desarrollo de Sistemas Nacionales de Servicios de Urgencia Médica. Programa de Organización y Gestión de Sistemas y Servicios de Salud (HSO), División de Desarrollo de Sistemas y Servicios de Salud (HSP), Organización Panamericana de la Salud, Organización Mundial de la Salud. Diciembre, 1998.

21. Barish PA, Doherty RJ. The potential impact of health care reform on the emergency department utilization. J Emerg Med 1995;13(5):675-678.

22. Trejo-López JA, Contreras-González N, García-Nava G, Arizmendi-García H. El servicio de urgencias en un hospital de tercer nivel. Su comportamiento durante cinco años: estudio preliminar. Med Int Mex 1999;156:257-259.

23. Grife CA, Gaos SC, Alcover SJ. Un año de expe-riencia en un servicio de atención prehospitalaria de Urgencias. Rev Asoc Mex Med Crit Ter Int 1987; 1:9-16.

24. Eastman AB. Blood in our streets. The status and evolution of trauma care systems. Arch Surg 1992; 127:677-681.

25. Landry J. Federal legislative impact on emergency medicine practice. Emerg Med Clin N Am 1987;5: 131-140.

26. Cairns CB, Garrison HG, Hedges JR, Schriger DL, Valenzuela TD. Development of new methods to assess the outcomes of emergency care. Acad Emerg Med 1998;5(2):157-161.

27. Reporte de condiciones de salud en México. INEGI 2000. http://www.inegi.gob.mx/difusión/espanol/fiecons.html

28. Loría-Castellanos J, Chavarría-Islas R. Experiencia médico-quirúrgica en una unidad de reanimación. Rev Med IMSS 2002;40(6):511-519.