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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer por qu&#233; las personas acuden a los servicios de urgencia hospitalarios &#40;SUH&#41; por problemas de salud de baja complejidad&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; una investigaci&#243;n cualitativa de tipo fenomenol&#243;gica interaccionista&#46; La muestra te&#243;rica pertenec&#237;a a un &#225;rea urbana y otra rural de Catalu&#241;a&#46; Se escogieron personas &#40;n &#61; 36&#41; que hab&#237;an acudido a los SUH o a servicios de urgencia de la atenci&#243;n primaria de salud &#40;SUAP&#41; en el mes previo a su selecci&#243;n&#46; Se recogieron datos en 8 grupos focales&#46; Se realiz&#243; un an&#225;lisis inductivo descriptivo-interpretativo&#44; construyendo categor&#237;as emergentes a partir de la triangulaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Emergieron 5 categor&#237;as&#58; s&#237;ntomas&#44; elaboraci&#243;n de autodiagn&#243;stico&#44; percepci&#243;n de necesidad&#44; conocimiento de la oferta y contexto global de la persona&#46; Los s&#237;ntomas generan la consideraci&#243;n de p&#233;rdida de salud y desencadenan la acci&#243;n&#46; La elaboraci&#243;n del autodiagn&#243;stico determina la necesidad-tipo de atenci&#243;n&#46; Del contraste entre la percepci&#243;ntipo de necesidad y el conocimiento de la oferta de los servicios&#44; as&#237; como de la situaci&#243;n vital de la persona&#44; surge la decisi&#243;n de acudir a un servicio u otro y se genera la acci&#243;n&#46; El conocimiento de la oferta de los SUH es mejor que el de los SUAP&#46; El tiempo parece b&#225;sico en la toma de decisiones&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La elaboraci&#243;n de un autodiagn&#243;stico es cr&#237;tica en la determinaci&#243;n de la acci&#243;n&#44; pero el conocimiento de la oferta de los servicios&#44; las experiencias previas y la situaci&#243;n vital de la persona modulan el tipo de demanda&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To ascertain why people attend hospital emergency departments &#40;ED&#41; for low complexity health problems&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p class="elsevierStyleSimplePara elsevierViewall">A phenomenological&#44; interactionist&#44; qualitative study was performed&#46; A theoretical sample that selected one urban and one rural area from Catalonia &#40;Spain&#41; was designed&#46; In each setting&#44; persons &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&#41; who had used the ED or a primary care emergency service 1 month before the beginning of the study were chosen&#46; Data were obtained through 8 focus groups&#46; An interpretative content analysis was performed&#44; and emergent categories were constructed through research triangulation&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Five categories emerged&#58; symptoms&#44; whether or not self-diagnosis was involved&#44; perception of needs&#44; awareness of the health services available&#44; and the overall context of the person&#46; Symptoms generated feelings of failing health and thus initiated care seeking&#46; Self-diagnosis determined perceived need and the type of care sought&#46; People contrasted their selfperception of need with their own opinion about the health services available&#46; The decision to go to one or other service was made as a result of this contrast&#44; but the individual&#8217;s family&#44; work&#44; and social situations also played a part&#46; Informants were more familiar with the service provided by the ED than with that provided by primary care&#46; Time consumption also figured heavily in decision making&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The presence or absence of self-diagnosis is a determining factor in attendance at EDs&#46; Other factors that influence demand are the level of awareness of the health services available&#44; previous experiences&#44; and the life situation of the individual&#46;</p>"
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                        "tituloSerie" => "Med Care Res Rev"
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                      "titulo" => "Nonurgent use of hospital emergency departments&#58; urgency from the patients&#8217;s perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;M&#46; Gill"
                            1 => "A&#46;W&#46; Riley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Fam Pract"
                        "fecha" => "1996"
                        "volumen" => "42"
                        "paginaInicial" => "491"
                        "paginaFinal" => "496"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8642367"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ambulatory visits to hospital emergency departments&#46; Patterns and reasons for use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;P&#46; Young"
                            1 => "M&#46;B&#46; Wagner"
                            2 => "M&#46;D&#46; Kellermann"
                            3 => "J&#46; Ellis"
                            4 => "D&#46; Bouley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1996"
                        "volumen" => "276"
                        "paginaInicial" => "460"
                        "paginaFinal" => "464"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8691553"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Priamry care and public emergency department overcrowding"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Grumbach"
                            1 => "D&#46; Keane"
                            2 => "A&#46; Brindman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Public Health"
                        "fecha" => "1993"
                        "volumen" => "83"
                        "paginaInicial" => "372"
                        "paginaFinal" => "378"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8438975"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonemergency emergency room use in patients with and without primary care physicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;I&#46; Haddy"
                            1 => "M&#46;E&#46; Schmaler"
                            2 => "R&#46;J&#46; Epting"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Fam Pract"
                        "fecha" => "1987"
                        "volumen" => "24"
                        "paginaInicial" => "389"
                        "paginaFinal" => "392"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3559491"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seeking care for nonurgent medical conditions in the emergency department&#58; throuh the eyes of the patient"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Kozio-McLain"
                            1 => "D&#46;W&#46; Price"
                            2 => "B&#46; Weiss"
                            3 => "A&#46;A&#46; Quinn"
                            4 => "B&#46; Honigman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/men.2000.110904"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Emerg Nurs"
                        "fecha" => "2000"
                        "volumen" => "26"
                        "paginaInicial" => "554"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11106453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An&#225;lisis de la demanda de asistencia sanitaria urgente con una base poblacional urbana &#91;tesis doctoral&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Le&#243;n-Sanrom&#224;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1992"
                        "editorial" => "Universitat Aut&#242;noma de Barcelona"
                        "editorialLocalizacion" => "Bellaterra"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Too much medicine&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Moynihan"
                            1 => "R&#46; Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2002"
                        "volumen" => "324"
                        "paginaInicial" => "859"
                        "paginaFinal" => "860"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11950716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La medicalizaci&#243;n de la vida y sus protagonistas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; M&#225;rquez"
                            1 => "R&#46; Meneu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gest Clin Sanit"
                        "fecha" => "2003"
                        "volumen" => "5"
                        "paginaInicial" => "47"
                        "paginaFinal" => "53"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors influents en la conducta de la poblaci&#243; per escollir el servei d&#8217;urg&#232;ncies hospitalari com a lloc d&#8217;atenci&#243;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;I&#46; Pasar&#237;n Rua"
                            1 => "J&#46; Calafell Cremades"
                            2 => "D&#46; Rodr&#237;guez Arjona"
                            3 => "M&#46;J&#46; Fern&#225;ndez de Sanmamed"
                            4 => "C&#46; Borrell Thi&#243;"
                            5 => "G&#46; Torras Boatella"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2004"
                        "editorial" => "Ag&#232;ncia d&#8217;Avaluaci&#243; de Tecnologia i Recerca M&#232;diques de Catalunya&#44; Departament de Sanitat i Seguretat Social"
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                    ]
                  ]
                ]
              ]
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Vol. 20. Núm. 2.
Páginas 91-99 (marzo - abril 2006)
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Vol. 20. Núm. 2.
Páginas 91-99 (marzo - abril 2006)
Originales
Open Access
Razones para acudir a los servicios de urgencias hospitalarios. La población opina
Reasons for attending emergency departments. People speak out
Visitas
1162
M. Isabel Pasarína,
Autor para correspondencia
mpasarin@aspb.es

Correspondencia: Dra. M. Isabel Pasarín. Agència de Salut Pública de Barcelona. Pl. Lesseps, 1. 08023 Barcelona. España.
, M. José Fernández de Sanmamedb, Joana Calafella, Carme Borrella, Dolors Rodrígueza, Salvador Campasolc, Elvira Tornéd, M. Glòria Torrase, Alex Guargad, Antoni Plasènciaa,f
a Agència de Salut Pública de Barcelona, Barcelona, España
b Institut Català de la Salut, Barcelona, España
c Regió Sanitària de Girona, Servei Català de la Salut, Girona, España
d Consorci Sanitari de Barcelona, Barcelona, España
e Hospital Universitari Vall d’Hebron, Barcelona, España
f Direcció General de Salut Pública, Departament de Salut, Generalitat de Catalunya, Barcelona, España
Este artículo ha recibido

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Información del artículo
Resumen
Objetivo

Conocer por qué las personas acuden a los servicios de urgencia hospitalarios (SUH) por problemas de salud de baja complejidad.

Método

Se realizó una investigación cualitativa de tipo fenomenológica interaccionista. La muestra teórica pertenecía a un área urbana y otra rural de Cataluña. Se escogieron personas (n = 36) que habían acudido a los SUH o a servicios de urgencia de la atención primaria de salud (SUAP) en el mes previo a su selección. Se recogieron datos en 8 grupos focales. Se realizó un análisis inductivo descriptivo-interpretativo, construyendo categorías emergentes a partir de la triangulación.

Resultados

Emergieron 5 categorías: síntomas, elaboración de autodiagnóstico, percepción de necesidad, conocimiento de la oferta y contexto global de la persona. Los síntomas generan la consideración de pérdida de salud y desencadenan la acción. La elaboración del autodiagnóstico determina la necesidad-tipo de atención. Del contraste entre la percepcióntipo de necesidad y el conocimiento de la oferta de los servicios, así como de la situación vital de la persona, surge la decisión de acudir a un servicio u otro y se genera la acción. El conocimiento de la oferta de los SUH es mejor que el de los SUAP. El tiempo parece básico en la toma de decisiones.

Conclusiones

La elaboración de un autodiagnóstico es crítica en la determinación de la acción, pero el conocimiento de la oferta de los servicios, las experiencias previas y la situación vital de la persona modulan el tipo de demanda.

Palabras clave:
Utilización servicios de urgencias
Urgencias inadecuadas
Motivos de utilización
Investigación cualitativa
Abstract
Objective

To ascertain why people attend hospital emergency departments (ED) for low complexity health problems.

Method

A phenomenological, interactionist, qualitative study was performed. A theoretical sample that selected one urban and one rural area from Catalonia (Spain) was designed. In each setting, persons (n=36) who had used the ED or a primary care emergency service 1 month before the beginning of the study were chosen. Data were obtained through 8 focus groups. An interpretative content analysis was performed, and emergent categories were constructed through research triangulation.

Results

Five categories emerged: symptoms, whether or not self-diagnosis was involved, perception of needs, awareness of the health services available, and the overall context of the person. Symptoms generated feelings of failing health and thus initiated care seeking. Self-diagnosis determined perceived need and the type of care sought. People contrasted their selfperception of need with their own opinion about the health services available. The decision to go to one or other service was made as a result of this contrast, but the individual’s family, work, and social situations also played a part. Informants were more familiar with the service provided by the ED than with that provided by primary care. Time consumption also figured heavily in decision making.

Conclusions

The presence or absence of self-diagnosis is a determining factor in attendance at EDs. Other factors that influence demand are the level of awareness of the health services available, previous experiences, and the life situation of the individual.

Key words:
Emergency department utilization
Inappropriate use
Reasons for utilization
Qualitative research
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Bibliografía
[1.]
S. Peiró, T. Sempere Selva, D. Oterino de la Fuente.
Efectividad de las intervenciones para reducir la utilización inapropiada de los servicios hospitalarios de urgencias. Revisando la literatura 10 años después del Informe del Defensor del Pueblo.
Economía y Salud, 33 (1999), pp. 3-12
[2.]
J. Lloret, S. Aregall.
Reflexions sobre el passat, present i futur dels serveis hospitalaris d’urgències.
Ann Med, 85 (2002), pp. 122-125
[3.]
J.M. Gill.
Use of hospital emergency departments for nonurgent care: a persistent problem with no easy solutions.
Am J Manag Care, 5 (1999), pp. 1565-1568
[4.]
P.J. Cunningham, C.M. Clancy, J.W. Cohen, M. Wilets.
The use of hospital emergency departments for nonurgent health problems: a national perspective.
Med Care Res Rev, 52 (1995), pp. 453-474
[5.]
D.W. Baker, C.D. Stevens, R.H. Brook.
Determinants of emergency department use by ambulatory patients at an urban public hospital.
Ann Emerg Med, 25 (1995), pp. 311-316
[6.]
J.M. Gill, A.W. Riley.
Nonurgent use of hospital emergency departments: urgency from the patients’s perspective.
J Fam Pract, 42 (1996), pp. 491-496
[7.]
G.P. Young, M.B. Wagner, M.D. Kellermann, J. Ellis, D. Bouley.
Ambulatory visits to hospital emergency departments. Patterns and reasons for use.
JAMA, 276 (1996), pp. 460-464
[8.]
K. Grumbach, D. Keane, A. Brindman.
Priamry care and public emergency department overcrowding.
Am J Public Health, 83 (1993), pp. 372-378
[9.]
R.I. Haddy, M.E. Schmaler, R.J. Epting.
Nonemergency emergency room use in patients with and without primary care physicians.
J Fam Pract, 24 (1987), pp. 389-392
[10.]
J. Kozio-McLain, D.W. Price, B. Weiss, A.A. Quinn, B. Honigman.
Seeking care for nonurgent medical conditions in the emergency department: throuh the eyes of the patient.
J Emerg Nurs, 26 (2000), pp. 554-563
[11.]
M. León-Sanromà.
Análisis de la demanda de asistencia sanitaria urgente con una base poblacional urbana [tesis doctoral].
Universitat Autònoma de Barcelona, (1992),
[12.]
R. Moynihan, R. Smith.
Too much medicine?.
BMJ, 324 (2002), pp. 859-860
[13.]
S. Márquez, R. Meneu.
La medicalización de la vida y sus protagonistas.
Gest Clin Sanit, 5 (2003), pp. 47-53
[14.]
M.I. Pasarín Rua, J. Calafell Cremades, D. Rodríguez Arjona, M.J. Fernández de Sanmamed, C. Borrell Thió, G. Torras Boatella, et al.
Factors influents en la conducta de la població per escollir el servei d’urgències hospitalari com a lloc d’atenció.
Agència d’Avaluació de Tecnologia i Recerca Mèdiques de Catalunya, Departament de Sanitat i Seguretat Social, (2004),
Copyright © 2006. Sociedad Española de Salud Pública y Administración Sanitaria
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