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Authors
Abstract(s)
Introdução: Os hiperutilizadores constituem, por definição, uma pequena percentagem
dos utilizadores do Serviço de Urgência (SU), mas são responsáveis por uma grande
proporção dos episódios de urgência. Este padrão de utilização não só tem implicações a
nível do consumo de recursos humanos e materiais como também prejudica a capacidade
de tratar os doentes de forma atempada.
Objetivo: O principal objetivo do presente estudo foi identificar os utilizadores frequentes
e as suas características, assim como apurar a existência de fatores precipitantes da
recorrência ao SU.
Métodos: O estudo retrospetivo e observacional, incidiu sobre uma amostra de 308
utilizadores frequentes adultos do Serviço de Urgência do Hospital Amato Lusitano,
durante o ano de 2018. Foram recolhidos dados clínicos e sociodemográficos por análise
dos episódios de urgência. A variável de interesse foi dividida em dois grupos de utilização:
“utilizadores moderadamente frequentes” e “utilizadores muito frequentes”. Recorreu-se a
técnicas de estatística descritiva, inferencial e análise de regressão logística binária.
Resultados: Foram identificados 6,6% utentes frequentes que totalizaram 21,1% de todas
as visitas. São maioritariamente do sexo feminino (57,1%), idosos (57,4%), com várias
patologias crónicas (71,1%) e consumo, em média, de 5 fármacos (5,19 ±3,75). São
beneficiários de taxas moderadoras (58,4%) e possuem um baixo nível de escolaridade
(71,7%). Habitar em domicílio próprio (OR=6,529; IC95%=[1,493; 28,550]) e apresentar
queixas mais diversas (OR=2,738; IC95%=[1,546; 4,849]) propiciam as múltiplas vindas.
Conclusão: Os utilizadores frequentes são uma população envelhecida e debilitada pela
carga de doença e polimedicação associadas. A implementação de intervenções
personalizadas tem como objetivo a melhoria de cuidados desta população.
Background: Frequent users comprise a small proportion of Emergency Department (ED) users, nevertheless they account for a considerably high proportion of emergency episodes. This pattern of use not only has implications in the consumption of human and material resources, but also impairs the ability to treat patients in a prompt manner. Objective: The main goal of this study is to identify frequent users and their characteristics, as well as to determine the existence of contributing factors for ED revisits. Methods: This retrospective and observational study focused on a sample of 308 adult frequent users of the Emergency Department of Hospital Amato Lusitano during 2018. Clinical and sociodemographic data were collected through the analysis of ED records. The variable of interest was categorized in two groups: “moderately frequent users” and “high frequent users”. Descriptive and inferential analysis was performed, as well as binary logistic regression. Results: We identified 6,6% frequent users who accounted for 21,1% of all visits. They were mostly female (57,1%), elderly (57,4%), with several chronic diseases (71,1%) and an average consumption of 5 drugs (5,19 ±3,75). The majority was exempt from hospital fees (58,4%) and had a lower education level (71,7%). Living in their own home (OR=6,529; IC95%=[1,493; 28,550]) and presenting more diverse complaints (OR=2,738; IC95%=[1,546; 4,849]) are conducive factors to multiple visits. Conclusion: Frequent users are an aged population, vulnerable due to the associated disease burden and polypharmacy. Implementation of personalized interventions aims to improve the care of this population.
Background: Frequent users comprise a small proportion of Emergency Department (ED) users, nevertheless they account for a considerably high proportion of emergency episodes. This pattern of use not only has implications in the consumption of human and material resources, but also impairs the ability to treat patients in a prompt manner. Objective: The main goal of this study is to identify frequent users and their characteristics, as well as to determine the existence of contributing factors for ED revisits. Methods: This retrospective and observational study focused on a sample of 308 adult frequent users of the Emergency Department of Hospital Amato Lusitano during 2018. Clinical and sociodemographic data were collected through the analysis of ED records. The variable of interest was categorized in two groups: “moderately frequent users” and “high frequent users”. Descriptive and inferential analysis was performed, as well as binary logistic regression. Results: We identified 6,6% frequent users who accounted for 21,1% of all visits. They were mostly female (57,1%), elderly (57,4%), with several chronic diseases (71,1%) and an average consumption of 5 drugs (5,19 ±3,75). The majority was exempt from hospital fees (58,4%) and had a lower education level (71,7%). Living in their own home (OR=6,529; IC95%=[1,493; 28,550]) and presenting more diverse complaints (OR=2,738; IC95%=[1,546; 4,849]) are conducive factors to multiple visits. Conclusion: Frequent users are an aged population, vulnerable due to the associated disease burden and polypharmacy. Implementation of personalized interventions aims to improve the care of this population.
Description
Keywords
Características Sociodemográficas Multimorbilidade Polimedicação Serviço de Urgência Utilizadores Frequentes