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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Desde hace 10 a&#241;os&#44; la Empresa P&#250;blica de Emergencias Sanitarias de Andaluc&#237;a estudia la concordancia de sus equipos con la atenci&#243;n primaria y los hospitales&#46; Se investiga el acuerdo diagn&#243;stico entre estos equipos y los hospitalarios&#44; y en caso de encontrar diferencias&#44; se valora si &#233;stas podr&#237;an estar en funci&#243;n del equipo de emergencias&#44; el recurso de traslado o el centro hospitalario&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo&#46; Se incluy&#243; a 510 pacientes &#40;seleccionados al azar&#41; cuyos datos se conoc&#237;a&#44; atendidos por equipos 061 de M&#225;laga en 2001 y que precisaron traslado a alg&#250;n hospital p&#250;blico&#46; Se recabaron datos sobre la filiaci&#243;n&#44; la asistencia recibida&#44; el traslado&#44; el centro hospitalario y el diagn&#243;stico&#46; El m&#225;ximo de diagn&#243;sticos permitidos fue 3&#44; codificados seg&#250;n la clasificaci&#243;n CIE-9 MC&#46; Para la comparaci&#243;n se utiliz&#243; el &#237;ndice kappa&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se perdieron 10 casos&#46; La media de diagn&#243;sticos del 061 por paciente fue de 1&#44;48&#44; mientras que en los informes hospitalarios fue de 1&#44;59&#46; Los m&#225;s frecuentes hac&#237;an referencia a traumatismos y enfermedades cardiovasculares &#40;los inespec&#237;ficos se aproximaron al 20&#37;&#41;&#46; El 59&#37; de los pacientes ten&#237;a al menos un diagn&#243;stico coincidente&#46; Para un nivel de confianza del 95&#37; obtuvimos un &#237;ndice kappa de 0&#44;478 &#40;proporci&#243;n de conformidad del 73&#44;9&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Obtuvimos una concordancia global moderada&#44; con mejores resultados para el Equipo de Coordinaci&#243;n Avanzada y traslados en ambulancia convencional por la simplicidad de los diagn&#243;sticos&#46; S&#243;lo lleg&#243; a niveles considerados como &#171;buenos&#187; el Hospital Costa del Sol&#44; con el que se comparten las gu&#237;as de trabajo&#46; El porcentaje de diagn&#243;sticos poco precisos fue alto&#46; Las propuestas de mejora deber&#225;n ir desde la revisi&#243;n de los modos de trabajo hasta la aplicaci&#243;n de nuevas tecnolog&#237;as&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Over the last 10 years the Public Health Emergency Service of Andalusia &#40;Spain&#41; has been conducting a study into the diagnostic agreement among its teams &#40;061 teams&#41; and those of primary care and hospitals&#46; Diagnostic agreement between these teams and hospital teams was evaluated&#46; When discrepancies were found&#44; an assessment was made of whether these corresponded to the emergency team&#44; transfer resources or hospital&#46;</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A descriptive study was performed&#46; Five hundred ten patients whose particulars were already known were randomly selected&#46; The patients&#44; who required transfer to a public hospital&#44; received assistance from 061 teams in Malaga in 2001&#46; Data were gathered on personal details&#44; the assistance received&#44; transfer&#44; hospital and diagnosis or diagnoses&#46; The maximum number of diagnoses permitted was three&#44; coded in accordance with the CIE-9 CM classification&#46; The Kappa index was used for comparisons&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ten cases were lost due to missing data&#46; The mean number of diagnoses per patient was 1&#46;48 for 061 teams and was 1&#46;50 in hospital reports&#46; The most common of diagnoses related to injuries and cardiovascular diseases &#40;non-specific diagnoses accounted for approximately 20&#37;&#41;&#46; Fifty-nine percent of the patients had at least one diagnosis that coincided&#46; We obtained &#234; &#61; 0&#46;478 for a confidence level of 95&#37; &#40;the agreement rate was 73&#46;9&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Overall agreement was moderate&#44; with better results in the Advanced Coordination Team and conventional ambulance transfer due to the simplicity of the diagnoses&#46; Results classified as &#171;good&#187; were achieved only in the Hospital Costa del Sol&#44; which uses working guidelines similar to those of the Public Health Emergency Service&#46; The percentage of inexact diagnoses was high&#46; Proposals for improvement should range from revising the working methods used to applying new technologies&#46;</p>"
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Acuerdo diagnóstico entre equipos de emergencias y servicios hospitalarios
Diagnostic agreement between emergency teams and hospital services
José M. Fernández-Cotrinaa,
Autor para correspondencia
jfcotrina@vodafone.es

Correspondencia: Arquitecto Alonso Carbonell, 14. 29018 Málaga. España.
, Antonio J. García-Ruizb, Mercedes Márquez-Castillab, Olga Jiménez-Guerreroa, Eduardo Reina-Caballeroa, Ana Bocanegra-Péreza, Felipe Sánchez de la Cuestab
a Empresa Pública de Emergencias Sanitarias (EPES)-061. Málaga
b Departamento de Farmacología y Terapéutica Clínica. Facultad de Medicina. Universidad de Málaga (UMA). Málaga
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Desde hace 10 a&#241;os&#44; la Empresa P&#250;blica de Emergencias Sanitarias de Andaluc&#237;a estudia la concordancia de sus equipos con la atenci&#243;n primaria y los hospitales&#46; Se investiga el acuerdo diagn&#243;stico entre estos equipos y los hospitalarios&#44; y en caso de encontrar diferencias&#44; se valora si &#233;stas podr&#237;an estar en funci&#243;n del equipo de emergencias&#44; el recurso de traslado o el centro hospitalario&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo&#46; Se incluy&#243; a 510 pacientes &#40;seleccionados al azar&#41; cuyos datos se conoc&#237;a&#44; atendidos por equipos 061 de M&#225;laga en 2001 y que precisaron traslado a alg&#250;n hospital p&#250;blico&#46; Se recabaron datos sobre la filiaci&#243;n&#44; la asistencia recibida&#44; el traslado&#44; el centro hospitalario y el diagn&#243;stico&#46; El m&#225;ximo de diagn&#243;sticos permitidos fue 3&#44; codificados seg&#250;n la clasificaci&#243;n CIE-9 MC&#46; Para la comparaci&#243;n se utiliz&#243; el &#237;ndice kappa&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se perdieron 10 casos&#46; La media de diagn&#243;sticos del 061 por paciente fue de 1&#44;48&#44; mientras que en los informes hospitalarios fue de 1&#44;59&#46; Los m&#225;s frecuentes hac&#237;an referencia a traumatismos y enfermedades cardiovasculares &#40;los inespec&#237;ficos se aproximaron al 20&#37;&#41;&#46; El 59&#37; de los pacientes ten&#237;a al menos un diagn&#243;stico coincidente&#46; Para un nivel de confianza del 95&#37; obtuvimos un &#237;ndice kappa de 0&#44;478 &#40;proporci&#243;n de conformidad del 73&#44;9&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Obtuvimos una concordancia global moderada&#44; con mejores resultados para el Equipo de Coordinaci&#243;n Avanzada y traslados en ambulancia convencional por la simplicidad de los diagn&#243;sticos&#46; S&#243;lo lleg&#243; a niveles considerados como &#171;buenos&#187; el Hospital Costa del Sol&#44; con el que se comparten las gu&#237;as de trabajo&#46; El porcentaje de diagn&#243;sticos poco precisos fue alto&#46; Las propuestas de mejora deber&#225;n ir desde la revisi&#243;n de los modos de trabajo hasta la aplicaci&#243;n de nuevas tecnolog&#237;as&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Over the last 10 years the Public Health Emergency Service of Andalusia &#40;Spain&#41; has been conducting a study into the diagnostic agreement among its teams &#40;061 teams&#41; and those of primary care and hospitals&#46; Diagnostic agreement between these teams and hospital teams was evaluated&#46; When discrepancies were found&#44; an assessment was made of whether these corresponded to the emergency team&#44; transfer resources or hospital&#46;</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A descriptive study was performed&#46; Five hundred ten patients whose particulars were already known were randomly selected&#46; The patients&#44; who required transfer to a public hospital&#44; received assistance from 061 teams in Malaga in 2001&#46; Data were gathered on personal details&#44; the assistance received&#44; transfer&#44; hospital and diagnosis or diagnoses&#46; The maximum number of diagnoses permitted was three&#44; coded in accordance with the CIE-9 CM classification&#46; The Kappa index was used for comparisons&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ten cases were lost due to missing data&#46; The mean number of diagnoses per patient was 1&#46;48 for 061 teams and was 1&#46;50 in hospital reports&#46; The most common of diagnoses related to injuries and cardiovascular diseases &#40;non-specific diagnoses accounted for approximately 20&#37;&#41;&#46; Fifty-nine percent of the patients had at least one diagnosis that coincided&#46; We obtained &#234; &#61; 0&#46;478 for a confidence level of 95&#37; &#40;the agreement rate was 73&#46;9&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Overall agreement was moderate&#44; with better results in the Advanced Coordination Team and conventional ambulance transfer due to the simplicity of the diagnoses&#46; Results classified as &#171;good&#187; were achieved only in the Hospital Costa del Sol&#44; which uses working guidelines similar to those of the Public Health Emergency Service&#46; The percentage of inexact diagnoses was high&#46; Proposals for improvement should range from revising the working methods used to applying new technologies&#46;</p>"
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ISSN: 02139111
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