Evaluation of the inappropriate use of emergency services of a social security hospital in Lima, Peru
DOI:
https://doi.org/10.54495/Rev.Cientifica.v28i2.53Keywords:
Emergency medical services, health services, health services misuseAbstract
Inappropriate use of emergency services is defined as the misuse of emergency room services for pathologies that could be attended as a non-urgent basis, either at an outpatient or in primary services. The purpose of this research was to find some characteristics associated with this misuse. Analytical cross sectional study, in which a random sample of users of the emergency service of the National Hospital “Guillermo Almenara” who met the selection criteria from April to November 2015, was administered. The bivariate analysis identified seven significant variables related to the inappropriate use: female gender (OR = 1.49, 95% CI [1.07, 2.08], p = .018), presence of chronic disease (OR = 0.50, 95% CI [0.35, 0.72], p < .001), perception of absence of equipment at primary level (OR = 2.56, 95% CI [1.66, 3.94], p < .001), perception of absence of specialists at primary level (OR = 2.25, 95% CI [1.43, 3.55], p < .001), self-reference (OR = 1.69, 95% CI [1.12, 2.57], p = .012), perception that the tertiary level care costs equal or less (OR = 2.02, 95% CI [1.42, 2.89], p < .001), and being at work when deciding to go to emergency (OR = 1.87, 95% CI [1.12, 3.13], p = .015). The multivariate analysis identified three significant variables: perception of absence of equipment at primary level (Adj. OR = 2.21, IC95% [1.42, 3.44], p < .001), self-reference (Adj. OR = 1.72, 95% CI, [1.05, 2.77], p = .032), and lower cost perception (Adj. OR = 2.0, 95% CI [1.35, 3.09], p = .001). The presence of chronic disease, the perception of lack of equipment, and specialists at the primary level were the variables that were most strongly associated with the inappropriate use of emergency services.
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