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

Abstract

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.