[Physical structure, human resources, and health care quality indicators in public hospital emergency departments in the autonomous communities of Madrid and Catalonia: a comparative study]
- PMID: 29188911
[Physical structure, human resources, and health care quality indicators in public hospital emergency departments in the autonomous communities of Madrid and Catalonia: a comparative study]
Abstract
Objectives: To compare the general, structural, and organizational characteristics of public hospital emergency departments in the Spanish autonomous communities of Madrid and Catalonia.
Material and methods: Descriptive survey-based study covering 3 areas of inquiry: general hospital features (18 questions), structural features of the emergency department (14 questions), and organizational and work-related policies of the emergency department (30 questions). Hospitals were grouped according to complexity: local hospitals (level 1), high-technology or referral hospitals (levels 2-3).
Results: We studied 26 hospital departments in Madrid (21, levels 2-3; 5, level 1) and 55 in Catalonia (24, levels 2-3; 31, level 1). Hospitals in Madrid are in newer buildings (P=.002), have more beds on conventional wards and in critical care units (P<.001, both comparisons), are more often affiliated with a university (P<.001), and serve larger populations (P=.027). The emergency departments in Madrid have larger surface areas available for clinical care and more cubicles for preliminary evaluations and observation beds (P=.001, all comparisons). Hospitals in Madrid also attended a larger median number of emergencies (P<.001). More physicians were employed in Catalonia overall, but the numbers of physician- and nurse-hours per hospital were higher in Madrid, where it was more usual for physicians to work exclusively in the emergency department (92.5% in Madrid vs 56.8% in Catalonia, P<.001). However, fewer of the employed physicians had permanent contracts in Madrid (30.5% vs 75.1% in Catalonia, P<.001). The ratio of resident physicians to staff physicians differs between the 2 communities on afternoon/evening, night, and holiday shifts (3:1 in Madrid; 1:1 in Catalonia).
Conclusion: The physical and functional structures of hospital emergency departments in the communities of Madrid and Catalonia differ significantly. The differences cannot be attributed exclusively to geographic location.
Objetivo: Comparar las características generales, estructurales y organizativas de los servicios de urgencias de hospitales públicos (SUHP) de la Comunidad de Madrid con los de Cataluña.
Metodo: Estudio descriptivo tipo encuesta estructurada con 3 apartados: aspectos generales del hospital (18 preguntas), aspectos generales y estructurales de urgencias (14 preguntas), y aspectos organizativos y laborales de urgencias (30 preguntas). Los centros se agruparon según complejidad: niveles I-hospital comarcal y niveles II y III-hospital de alta tecnología o de referencia.
Resultados: Se incluyeron los 26 SUHP de la Comunidad de Madrid (21 nivel II-III y 5 nivel I), y 55 de Cataluña (24 nivel II- III y 31 nivel I). En Madrid, comparada con Cataluña: los hospitales son de construcción más reciente (p = 0,002); tienen mayor número de camas de hospitalización (p < 0,001) y de cuidados críticos (p < 0,001); están más frecuentemente vinculados a la universidad (p < 0,001) y cubren mayor población (p = 0,027). Los servicios de urgencias: tienen mayor superficie para la actividad clínica (p < 0,001) y la primera asistencia (p < 0,001); mayor número de puestos de primera asistencia (p < 0,001) y camas de observación (p = 0,001) y la mediana del número de atenciones urgentes es mayor (p < 0,001). De forma global, hay más facultativos contratados en Cataluña, pero el número de horas de médico y enfermera contratadas por centro es mayor en Madrid, donde los médicos suelen realizar su actividad exclusivamente en urgencias (92,5% frente a 56,8%; p < 0,001), muy pocos con contrato fijo indefinido (30,5% frente a 75,1%; p < 0,001) con relación médico residente/adjunto diferente en turnos de tarde, noche y días festivos en comparación con los SUHP catalanes (3:1 frente a 1:1).
Conclusiones: La estructura física y funcional de los SUHP madrileños y catalanes difiere de forma significativa sin que pueda explicarse, exclusivamente, por los aspectos geográficos.
Keywords: Administración; Administration; Autonomous community of Madrid; Comunidad de Madrid; Emergency health services; Emergency medicine; Gestión; Health care resource planning; Medicina de Urgencias y Emergencias; Planificación; Servicios de Urgencias.
Comment in
-
[Hospital emergency services in Spain: Differences by autonomous community or by system of organization?].Emergencias. 2017 Dic;29(6):369-370. Emergencias. 2017. PMID: 29188909 Spanish. No abstract available.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
