Pérez Sánchez A, Begara De la Fuente M, Núñez Fúster J, Navarro González J
Hospital U. Infantil Virgen del Rocío, Sevilla.
An Esp Pediatr. 1996 Apr;44(4):321-5.
The objectives of this study were to analyze the social and clinical aspects of the infant and child population who excessively utilize the hospital emergency services. To this end, the clinical histories of 130 children admitted to a pediatric hospital have been analyzed. These children were between the ages of 2 months and 10 years and had 10 or more visits to the emergency room or had more than 4 visits during the same year. The control group was arbitrarily composed of 270 children admitted to the same service during the same period of time. We found that in the study group the sociocultural level was low in 71% and 17% had serious social deprivation (significant differences with the control population, p < 0.05). Twenty percent had at least one previous febrile convulsion (p < 0.001) and 33% had more than four hospital admissions. No significant differences in the number of urgent consultations were found between the different days of the week no between the different months. The most frequent diagnosis was upper respiratory tract infections. The number of consultations was higher (p < 0.05) in children with serious social deprivation, chronic pathology, multiple hospital admissions and whose home was near the hospital. We conclude that children with reiterative consultations to the hospital emergency services usually have a social level lower than the control group. Most of these consultations are caused by banal problems and the children are subjected to an excessive number of analytical and radiological tests. Therefore, adequate health education is necessary among these sociocultural level groups in order to avoid using the emergency services as primary attendance consultations.
本研究的目的是分析过度使用医院急诊服务的婴幼儿和儿童群体的社会及临床方面情况。为此，对一家儿科医院收治的130名儿童的临床病历进行了分析。这些儿童年龄在2个月至10岁之间，曾10次及以上前往急诊室就诊，或在同一年就诊次数超过4次。对照组由同期在同一科室收治的270名儿童组成，选取具有随机性。我们发现，在研究组中，71%的儿童社会文化水平较低，17%的儿童存在严重的社会剥夺情况（与对照组有显著差异，p < 0.05）。20%的儿童曾至少有一次高热惊厥（p < 0.001），33%的儿童住院次数超过4次。在一周的不同日期之间以及不同月份之间，紧急会诊次数未发现显著差异。最常见的诊断是上呼吸道感染。在存在严重社会剥夺、患有慢性疾病、多次住院且家离医院较近的儿童中，会诊次数更高（p < 0.05）。我们得出结论，反复前往医院急诊服务部门就诊的儿童，其社会水平通常低于对照组。这些会诊大多由常见问题引起，并且这些儿童接受了过多的分析和放射学检查。因此，有必要在这些社会文化水平群体中开展充分的健康教育，以避免将急诊服务用作初级就诊咨询。
