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At least 19 recordsLinked to original sources
PubMed1997

[Socioeconomic determinants and utilization of emergency hospital services].

BACKGROUND: Socioeconomic level is a key determinant for health status. It may also influence on the utilization of hospital emergency services, although the factor responsible for that is not known. The main objective of the present report is to assess whether patients using frequently hospital emergency services have one or more variables related to low socioeconomic level. PATIENTS AND METHODS: A standardized questionnaire was applied to 800 patients randomly selected from those attending the emergency services of a provincial reference hospital. It was gathered information on: income, education level, employment, loneliness, domestic violence, occupational accidents, and life style. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated. Stepwise logistic regression analysis was used to ascertain the independent predictors for attending for than once to the emergency services. RESULTS: In crude analysis, low income and low educational level were significantly related to the use of emergency services (both chi 2 for a trend < 0.05). Alcoholism (OR = 2.3, 95% CI = 1.2-4.7) and domestic violence (OR = 2.6, 95% CI = 0.9-8.1) were also related. Stepwise logistic regression analysis selected income (OR for intermediate level = 1.6, 95% CI = 1.0-2.7, and OR for low level = 2.3, 95% CI = 1.4-3.7) and alcoholism (OR = 2.9, 95% CI = 1.3-6.4) as independent predictors. CONCLUSIONS: Patients with low income and/or alcoholism use emergency hospital services more frequently.

Adult↗
PubMed1990

Socio-spatial perspectives on the utilization of emergency hospital services in two urban territories in Quebec.

Hospital emergency services located in urban areas have been severely congested for several years in the province of Quebec. This problem is not caused by ambulatory patients who are using emergency services as a regular source of care, but by patients in need of emergency services. To study the factors affecting the utilization rates of emergency services in two urban areas, the city of Laval and the Quebec metropolitan area, two samples of more than 30,000 patients each were drawn from the 1981 file of the Régie de l'assurance-maladie du Quebec. The utilization rates of emergency services for emergent and urgent causes in these two samples were computed on the basis of the census tract location of these patients. The socio-economic characteristics of these census tracts were taken from the 1981 Canadian census, the distance travelled from each census tract to the location of hospital emergency services was computed and included as a predictor of the utilization rates. Also, the prevalence of chronic and psychiatric diagnoses were obtained for each census tract. The result of the analysis showed that distance affected the utilization rates only in the Quebec metropolitan area where the hospitals are mostly located in the downtown area near deprived and working class neighbourhoods, while the socio-economic characteristics affected the utilization rates in both Quebec and Laval.

Age Factors↗
PubMed1993

A descriptive study of care processes using total quality management as a framework in a USAF regional hospital emergency service and related services.

The purpose of this descriptive study was to investigate access to care processes in a military regional hospital Emergency Service (ES) and related services using a Total Quality Management framework. Tabulations of demographic survey data revealed that the ES is used mainly as a primary care clinic, with a greater proportion of pediatric care provided during peak hours. An analysis of patterns of care processes in the organizational system revealed that there was little in common between Total Quality Management and Continuous Quality Improvement principles and the care processes. The results of the analysis lend support to the proposed USAF decentralized, coordinated health care system with more authority and control given to local commands and emphasis upon increased responsibility and accountability within professional and beneficiary communities.

Adolescent↗
PubMed1997

[Outpatient emergency care in pneumology. A method to alleviate pressure of hospital emergency services].

We analyze the result of using a pneumological rapid-attention facility for diagnosis and immediate treatment of patients with respiratory symptoms arriving at the emergency room of University Hospital Virgen del Rocío in Seville (Spain). In the first six months the outpatient service saw 321 patients (male/female ratio 2.6), most of whom were between 55 and 75 years of age and had never before seen a pneumologist (83.4%). Dyspnea was the most common respiratory symptom named (by 35% of patients), and acute exacerbation of chronic obstructive pulmonary disease was the most usual diagnosis (in 19.1%). Only 21 (7%) were admitted to the hospital. We that creating the outpatient unit effectively met a societal need for rapid diagnosis and treatment of patients with respiratory complaints in the area served by our hospital emergency service.

Adolescent↗
PubMed1996

[The frequency of the use of hospital emergency services: the motivations and characteristics of pediatric emergencies].

It is well known the high attendance frequency of the hospital emergency services (HES). In order to know the reason and justification of this demand, the emergency visits to the reference HES from a paediatrician population of our Health Center are studied. The results of a questionnaire of 304 emergencies are analyzed and compared with the level of frequency of the children to the HES. The follow-up of the emergency in the health center is also assessed. 82% of the emergencies attend the HES by themselves and the main reason to justify this behaviour were (up to two arguments): the paediatrician schedule unfit their requirements (55.5%), the likelihood to perform complementary tests (42.3%), rather than the severity of the process of the child (28.3%). The lower is the mean of brothers and sisters and the social class of the father, the higher is the frequency to the HES. 4.5% of the emergencies ended inpatient, and in 33% a complementary tests was performed. The lesser complementary tests are conducted the higher is the frequency to the HES (p = 0.001). Bases on the medical assessment, the emergency is justified in 28.1% of the cases, but it raised up to 44.4% when social arguments are also considered by the doctor who attended the emergency. 50% observe the advised to follow up in the Health Center, accomplishing better those with higher frequency. We consider that social and psychological elements of the children family, and the need to resolve the health problem as soon as possible, are two considerations more important than the severity of the process in the genesis of over-utilization of the HES.

Analysis of Variance↗
PubMed2003

[Generic drug prescription at discharge from a hospital emergency service].

BACKGROUND AND OBJECTIVE: Drug prescription at hospital discharge often implies continuation of the treatment in primary health care. The aim of this study was to assess prescription of generics at discharge from a hospital emergency service. MATERIAL AND METHOD: Longitudinal and retrospective study, on a random sample of medical reports in a hospital emergency service during one year (August 2000 to July 2001). Information on the medical specialty, prescribed generic drugs and marked availability of the corresponding generic drugs pharmaceutical specialties was collected. Factors associated with generic prescription were analyzed by means of logistic regression analysis. RESULTS: A sample of 1,245 medical reports was selected in which 2,315 drugs were prescribed. Although generic drugs were available for 33.3% (CI 95%, 31.4-35.2) of prescriptions, 9.5% (95% CI, 8.3-10.7) of prescribed drugs were generics. The average price of trademark prescribed medicines, for which there was a generic equivalent, was 7.09 Euros (95% CI, 6.54-7.63 Euros), and that of the corresponding generic versions was 5.08 Euros (95% CI, 4.68-5.48 Euros). Variables associated with generic drug prescription included the particular study period (OR=1.35; 95% CI, 0.99-1.84), the medical specialty of the prescriber (OR=1.40; 95% CI, 1.05-1.86), availability of generic drugs (OR=1.76; 95% CI, 1.30-2.39) and low price of prescribed drugs (OR=2.67; 95% CI, 1.80-3.98). CONCLUSION: In spite of the availability of generic drugs, prescription of generic drugs at discharge of this hospital emergency service was low. Prescription and use of generic drugs should be promoted in hospitals.

Costs and Cost Analysis↗
PubMed1987

Categorization of hospital emergency services--developing valid criteria.

In a pilot project sponsored by the California State Emergency Medical Services Authority, validated, verifiable criteria were developed for the vertical categorization of hospital emergency services in 11 different groupings of medical and surgical emergencies. We describe the development of an assessment process and categorization criteria to identify the most appropriate receiving facility for interfacility transfer and, in selected instances, field triage of patients with different levels of severity of illness or injury. We propose that this facility assessment project be used in the critical care planning process for the eventual vertical categorization of hospital emergency services in California and as a template for similar projects in other states.

California↗