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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluar la variaci&#243;n del indicador &#8220;periodo de tiempo de observaci&#243;n&#8221; dedicado a cada paciente&#44; en respuesta a una reducci&#243;n del n&#250;mero de camas disponibles&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio &#171;quasiexperimental preprueba postprueba&#187; sin grupo control en una unidad de urgencias durante 2 per&#237;odos de un mes&#46; En este tiempo el &#250;nico cambio fue el n&#250;mero de camas disponibles&#44; que disminuyeron de 20 &#40;per&#237;odo A&#41; a 16 &#40;per&#237;odo B&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El servicio de urgencias atendi&#243; a 7&#46;725 pacientes&#58; 3&#46;706 pacientes en el per&#237;odo A&#44; 335 de los cuales fueron admitidos en la unidad de observaci&#243;n con una estancia media de 1&#46;105&#44;4 minutos por paciente&#59; y 4&#46;019 pacientes en el per&#237;odo B&#44; 570 de los cuales fueron admitidos en la unidad de observaci&#243;n con una estancia media de 686&#44;1 minutos por paciente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; No hubo variaciones en la mortalidad&#44; readmisiones o quejas&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Una disminuci&#243;n en el n&#250;mero de camas disponibles para observaci&#243;n comporta una reducci&#243;n en el tiempo de estancia de los pacientes&#46;</p>"
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                            4 => "H&#46; Wong"
                            5 => "E&#46; Yu"
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                        "paginaFinal" => "738"
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                    ]
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16447109"
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                      ]
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                  ]
                ]
              ]
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                        0 => array:2 [
                          "etal" => false
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                      ]
                    ]
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                        "paginaFinal" => "444"
                      ]
                    ]
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                        "volumen" => "296"
                        "paginaInicial" => "95"
                        "paginaFinal" => "97"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16820553"
                            "web" => "Medline"
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                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Variaciones en la pr&#225;ctica m&#233;dica&#58; importancia&#44; causas e implicaciones"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Mari&#243;n Buen"
                            1 => "S&#46; Peir&#243;"
                            2 => "S&#46; M&#225;rquez Calder&#243;n"
                            3 => "R&#46; Meneu de Guillerna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1998"
                        "volumen" => "110"
                        "paginaInicial" => "382"
                        "paginaFinal" => "390"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inpatient general medicine is evidence-based"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Ellis"
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                            2 => "J&#46; Rowe"
                            3 => "D&#46;L&#46; Sackett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1995"
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                        "paginaInicial" => "407"
                        "paginaFinal" => "410"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7623571"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                    0 => array:2 [
                      "titulo" => "Emergency physicians&#8217; fear of malpractice in evaluating patients with possible acute cardiac ischemia"
                      "autores" => array:1 [
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                            2 => "R&#46;L&#46; Brown"
                            3 => "T&#46;P&#46; Aufderheide"
                            4 => "M&#46; Bogner"
                            5 => "P&#46;S&#46; Rahko"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.annemergmed.2005.04.016"
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                        "volumen" => "46"
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                        "link" => array:1 [
                          0 => array:2 [
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Vol. 21. Núm. 2.
Páginas 132-135 (marzo - abril 2007)
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Vol. 21. Núm. 2.
Páginas 132-135 (marzo - abril 2007)
Originales
Open Access
Influence of available resources on medical practitioners’ decision-making process and practice: study of a reference hospital emergency department
Visitas
959
Juan Viñas Salas
Autor para correspondencia
vinyes@cirurgia.udl.es

Correspondence: Juan Viñas Salas. Pintor Benseny, 7. 25008 Lleida. Spain.
, Ramón Casals Garrigó, Ana M. Jiménez Vilchez, Pere Godoy
Arnau de Vilanova University Hospital, School of Medicine, University of Lleida, Lleida, Spain
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Información del artículo
Abstract
Objective

To evaluate variations in the observation period in the emergency department (ED) in response to bed availability.

Methods

A quasi-experimental pre-test post-test study without a control group was conducted in the ED observation ward over 2 1-month periods. During this time the only variable that changed was the number of beds available, which decreased from 20 (pre-test period) to 16 (post-test period).

Results

The ED attended 7,725 patients: 3,706 patients in pre-test period, 335 of whom were admitted to the observation ward, with an average length of stay of 1,105.4 minutes per patient, and 4,019 patients in post-test period, 570 of whom were admitted to the observation ward, with an average length of stay of 686.1 minutes per patient (p<0.001). There was no variation in mortality, re-admissions or complaints.

Conclusions

A reduction in bed availability for observation purposes shortens patient length of stay.

Key words:
Health care management
Emergencies
Resources
Health care quality
Resumen
Objetivo

Evaluar la variación del indicador “periodo de tiempo de observación” dedicado a cada paciente, en respuesta a una reducción del número de camas disponibles.

Métodos

Se realizó un estudio «quasiexperimental preprueba postprueba» sin grupo control en una unidad de urgencias durante 2 períodos de un mes. En este tiempo el único cambio fue el número de camas disponibles, que disminuyeron de 20 (período A) a 16 (período B).

Resultados

El servicio de urgencias atendió a 7.725 pacientes: 3.706 pacientes en el período A, 335 de los cuales fueron admitidos en la unidad de observación con una estancia media de 1.105,4 minutos por paciente; y 4.019 pacientes en el período B, 570 de los cuales fueron admitidos en la unidad de observación con una estancia media de 686,1 minutos por paciente (p<0,001). No hubo variaciones en la mortalidad, readmisiones o quejas.

Conclusiones

Una disminución en el número de camas disponibles para observación comporta una reducción en el tiempo de estancia de los pacientes.

Palabras clave:
Gestión de servicios sanitarios
Urgencias
Recursos
Calidad de los servicios de salud
El Texto completo está disponible en PDF
Bibliografía
[1.]
W.F Peacock, J. Young, S. Collins, D. Diercks, C. Emerman.
Heart failure observation units: optimizing care.
Ann Emerg Med, 47 (2006), pp. 22-33
[2.]
J. Christenson, G. Innes, D. McKnight, C.R. Thompson, H. Wong, E. Yu, et al.
A clinical prediction rule for early discharge of patients with chest pain.
[3.]
J.L. Azpiazu.
Los frecuentadores de los servicios de urgencias.
Med Clin (Barc), 108 (1997), pp. 737-738
[4.]
G.P. Young, M.B. Wagner, A.L. Kellermann, J. Ellis, D. Bouley.
Ambulatory visits to hospital emergency departments.
JAMA, 276 (1996), pp. 460-465
[5.]
R. Steinbrook.
The role of emergency department.
N Engl J Med, 334 (1996), pp. 657-658
[6.]
M. Sánchez, O. Miró, B. Coll-Vinent, E. Bragulat, G. Espinosa, E. Gómez-Angelats, et al.
Saturación del servicio de urgencias: factores asociados y cuantificación.
Med Clin (Barc), 121 (2003), pp. 167-172
[7.]
A. Fernández Moyano, J.L. Callejas Rubio, M.I. Paredes García, D. Navarro Hidalgo.
Tiempos de espera y calidad asistencial en urgencias.
Med Clin (Barc), 117 (2001), pp. 559
[8.]
S. Peiró, R. Meneu, M.L. Roselló.
Validez del protocolo de evaluación del uso inapropiado de la hospitalización.
Med Clin (Barc), 107 (1996), pp. 1124-1129
[9.]
P. Mangtani, S. Hajat, S. Kovats, P. Wilkinson, B. Armstrong.
The association of respiratory syncitial virus infection and influenza with emergency admissions for respiratory disease in London: an anlysis of routine surveillance data.
Clin Infect Dis, 42 (2006), pp. 640-646
[10.]
J.L. González-Montalvo, J.J. Baztán, L. Rodríguez-Mañas.
Ingreso hospitalario urgente: factores sociales asociados y sus diferencias en función de la edad.
Med Clin (Barc), 103 (1994), pp. 441-444
[11.]
A.K. Jha.
Measuring hospital quality. What physicians do? How patients fare? or Both?.
JAMA, 296 (2006), pp. 95-97
[12.]
J. Marión Buen, S. Peiró, S. Márquez Calderón, R. Meneu de Guillerna.
Variaciones en la práctica médica: importancia, causas e implicaciones.
Med Clin (Barc), 110 (1998), pp. 382-390
[13.]
J. Ellis, I. Mulligan, J. Rowe, D.L. Sackett.
Inpatient general medicine is evidence-based.
Lancet, 346 (1995), pp. 407-410
[14.]
D.A. Katz, G.C. Williams, R.L. Brown, T.P. Aufderheide, M. Bogner, P.S. Rahko, et al.
Emergency physicians’ fear of malpractice in evaluating patients with possible acute cardiac ischemia.
Ann Emerg Med, 46 (2005), pp. 525-533
Copyright © 2007. Sociedad Española de Salud Pública y Administración Sanitaria
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