Oterino de la Fuente David, Baños Pino J F, Fernández Blanco V, Rodríguez-Alvarez A
Departamento de Medicina Preventiva y Salud Pública, Universidad de Oviedo.
Rev Esp Salud Publica. 2007 Mar-Apr;81(2):191-200. doi: 10.1590/s1135-57272007000200009.
Greater accessibility to the primary care continuing care points (CCP's) could reduce the visits to the Hospital Emergency Services (HES's). This study analyses whether Primary Care can replace and Hospital Services in emergencies.
All of the emergency visits (n=6.454.034) made to the HES's and Primary Care CCP's in Asturias and of each one of the healthcare districts within the 1994-2001 period were calculated. The time series were constructed with monthly frequencies for Asturias and each one of the districts, a cointegration analysis having been made to assess whether the two series are inter-replaceable.
A mean annual increase of the total number of emergencies in Asturias of 6.2% (CCP: 7,8%; HES: 5.1%) was found, with different growth among the healthcare districts. In the time series cointegration analysis, no replaceability was found between the primary care and hospital emergencies for Asturias and for the healthcare districts, except for the healthcare district of Oviedo, where a 10% growth rate in primary would lower hospital emergencies by 2.7%.
The greater accessibility to the Primary Care CCP's increases the use thereof without reducing the visits to the HES's. Therefore, the increase in Primary Cart resources does not seem to be an effective alternative for reducing the visits to the HES's.
增加基层医疗连续性照护点（CCP）的可及性可能会减少前往医院急诊服务（HES）的就诊次数。本研究分析了基层医疗在紧急情况下是否能够替代医院服务。
计算了1994 - 2001年期间阿斯图里亚斯以及每个医疗区前往HES和基层医疗CCP的所有急诊就诊次数（n = 6,454,034）。以阿斯图里亚斯和每个区的月度频率构建时间序列，并进行了协整分析以评估这两个序列是否可相互替代。
发现阿斯图里亚斯急诊总数年均增长6.2%（CCP：7.8%；HES：5.1%），各医疗区增长情况不同。在时间序列协整分析中，除了奥维耶多医疗区外，未发现阿斯图里亚斯和各医疗区的基层医疗急诊与医院急诊之间存在可替代性，在奥维耶多医疗区，基层医疗就诊量增长10%会使医院急诊量降低2.7%。
基层医疗CCP可及性的提高增加了其使用量，而未减少前往HES的就诊次数。因此，增加基层医疗资源似乎并不是减少前往HES就诊次数的有效替代方法。
