Publique un comentario 
Mal uso del servicio de emergencia pediátrica y lecciones de la pandemia de COVID-19 en Perú
Texto completo:
PDFResumen
Objetivo: Describir la variación de las visitas no urgentes al Servicio de Emergencia Pediátrica antes, durante y con posterioridad a la pandemia de COVID-19, según la categoría de prioridad.
Métodos: Se realizó un estudio transversal retrospectivo. Se utilizó la base de datos del Hospital de Emergencias Pediátricas de Lima, Perú, desde abril de 2019 hasta marzo de 2023. Se establecieron cuatro etapas: prepandemia, pandemia-etapa 1, pandemia-etapa 2 y pospandemia. La variable principal fue el nivel de prioridad: emergencia mayor, emergencia, urgencia mayor, urgencia menor y no urgencia.
Resultados: Se registraron 148,297 atenciones; de ellas, el 55,4 % correspondió al sexo masculino. Las afecciones más frecuentes fueron anormalidades clínicas (28,7 %), problemas respiratorios (24,2 %) e infecciosos/parasitarios (21,3 %). Las urgencias mayores representaron el 78 %. Hubo un incremento en las urgencias menores desde un 5 %, en el período prepandemia, hasta un 27,7 % en pospandemia. La mayoría de estas urgencias menores o no urgencias (73, 4 %) tuvo lugar entre semana y en horario diurno.
Conclusiones: Deben establecerse estrategias para prevenir la sobrecarga del Servicio de Emergencia con problemas de salud que puedan ser atendidos en consulta ambulatoria, y estandarizar las definiciones de visitas no urgentes.
Palabras clave
Referencias
O’Cathain A, Connell J, Long J, Coster J Clinically unnecessary use of emergency and urgent care: A realist review of patient’s decision making. Health Expect. 2020;23:19-40. DOI: https://doi.org/10.1111/hex.12995
Wise M. Inappropriate attendance in accidents and Emergency. Accident and Emergency Nursing. 1997 [acceso 01/04/2024];5(3):102-6. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0965230297900916?via%3Dihub
Isba R, Edge R, Jenner R, Broughton E, Francis N, Butler J. Where have all the children gone? Decreases in pediatric emergency department attendances at the start of the COVID-19 pandemic of 2020. Archs Dis Child. 2020 [acceso 01/04/2024];105(7). Disponible en: https://adc.bmj.com/content/105/7/704.1.long
Honeyford K, Coughian C, Nijman R, Expert P, Burcea G, Maconochie I, et al. Changes in emergency department activity and the first COVID-19 Lockdown: A cross-sectional study. West J Emergency Medicine. 2021 [acceso 24/03/2024];22(3):603-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203011
Dann L, Firtzsimons K, Gorman K, Hourihabe J, Okafor I. Disappearing act: COVID-19 and pediatrics emergency department attendances. Arch Dis Child. 2020 [acceso 26/03/2024];105(8):810-11. Disponible en: https://adc.bmj.com/content/105/8/810.long
Cajachagua-Torres KN, Quezada-Pinedo HG, Huayanay-Espinoza CA, Obeso-Manrique JA, Peña Rodriguez VA, Vidal E, et al. COVID-19 and drives of excess death rate in Peru: A longitudinal ecological study. Heliyon. 2022 [acceso 01/04/2024];8(12). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710104
Stramandinoli A, Alvarado-Zuñiga J, Alvarado GF, Esgúsquiza-Zuzunaga G, Carreazo NY. Comparative changes in emergency department patient attendance at the Pediatric Emergency Hospital during the first wave between 2019 and 2020. Rev Peru Med Exp Salud Publica. 2022 [acceso 25/03/2024];39(3):345-51. Disponible en: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/11245
Bahadori M, Mousavi SM, Teymourzadeh E, Ravangard R. Emergency department visits for non-urgent conditions in Iran: a cross-sectional study. BMJ Open. 2019;9(10). DOI: https://doi.org/10.1136/bmjopen-2019-030927
O’Keeffe C, Mason S, Jacques R, Nicholl J. Characterizing non-urgent users of the Emergency Department (ED): A retrospective analysis of routine ED data. PLOS One. 2018 [acceso 01/04/2024];13(2). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825051
Jaboyedoff M, Starvaggi C, Suris JC, Kuehni CE, Gehri M, Keitel K, et al. Characteristics of low-acuity paediatric emergency department consultations in two tertiary hospitals in Switzerland: a retrospective observational study. BMJ Paediatr Open. 2021 [acceso 20/03/2024];5(1). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634019
Alele FO, Callander EJ, Emeto T, Mills J, Watt K. Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department. J Paediatr Child Health. 2018 [acceso 18/03/2024];54(12):1341-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29863756
Melnick G, O’Leary JF, Zaniello BA, Abrishamian L. COVID-19 driven decline in emergency visits: Has it continued, is it permanent, and what does it mean for emergency physicians? Am J Emerg Med. 2022;61:64-7. DOI: https://doi.org/10.1016/j.ajem.2022.08.031
O’Carroll D. COVID-19 in emergency departments: Buckle up! United Kingdom. Medscape. 2021 [acceso 01/08/2023]. Disponible en: https://www.medscape.co.uk/viewarticle/covid-19-emergency-departments-buckle-2021a1001wg9
Plunkett-Reilly C. Health and Social Care Select Committee: Written evidence submitted by the Royal College of Pediatrics and Child Health. RCPCH. 2021 [acceso 01/08/2023]. Disponible en: https://www.rcpch.ac.uk/sites/default/files/2021-09/RCPCH%20%20clearing%20the%20backlog%20caused%20by%20the%20pandemic.pdf
Alele FO, Emeto TI, Callander EJ, Watt K. Non-urgent paediatric emergency department presentation: A systematic review. J Paediatr Child Health. 2019 [acceso 23/09/2023];55(3):271-7. Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/jpc.14352
Simpson RM, Keeffe C, Jacques R, Stone T, Hassan A, Mason S. Non-urgent emergency department attendances in children: a retrospective observational analysis. Emerg Med K. 2022 [acceso 03/04/2024];39:17-22. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717488
Ruiz-Frutos C, Palomino-Baldeón JC, Ortega-Moreno M, Villavicencio-Guardia MDC, Dias A, Bernardes JM, et al. Effects of the COVID-19 Pandemic on Mental Health in Peru: Psychological Distress. Healthcare (Basel). 2021;9(6). DOI: https://doi.org/10.3390/healthcare9060691
Galdos-Bejar MN, Belanovic Ramirez I, Santander Alva V, Tanaka J. Effects of the COVID-19 pandemic on the prevalence of obsessive-compulsive symptoms among young adults in Peru. J Publ Hlth Dev. 2022 [acceso 01/08/2023];20(2):137-51. Disponible en: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/256325
Butun A, Hemingway P. A qualitative systematic review of the reasons for parental attendance at the emergency department with children presenting with minor illness. Int Emerg Nurs. 2018;36:56-62. DOI: https://doi.org/10.1016/j.ienj.2017.07.002
Akbayram HT, Coskun E. Paediatric emergency department visits for non-urgent conditions: Can family medicine prevent this? Eur J Gen Pract. 2020 [acceso 10/04/2024];26(1):134-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28778488
Kurt F, Beğde F, Oğuz S, Tekin D, Suskan E. How Important Are Parental Age and Educational Level in Nonurgent Admissions to the Pediatric Emergency Department? Pediatr Emerg Care. 2020 [acceso 01/04/2024];36(9):414-8. Disponible en: https://journals.lww.com/peconline/abstract/2020/09000/how_important_are_parental_age_and_educational.2.aspx
Smith V, Mustafa M, Grafstein E, Doan Q. Factors Influencing the Decision to Attend a Pediatric Emergency Department for Nonemergent Complaints. Pediatr Emerg Care. 2015;31(9):640-4. DOI: https://doi.org/10.1097/PEC.0000000000000392
Krebs LD, Kirkland SW, Chetram R, Nikel T, Voaklander B, Davidson A, et al. Low-acuity presentations to the emergency department in Canada: exploring the alternative attempts to avoid presentation. Emerg Med J. 2017;34(4):249-255. DOI: https://doi.org/10.1136/emermed-2016-205756
McLauchlan K, Ramlakhan S, Irving A. Why do parents present to the Paediatric Emergency Department with conditions suitable for management in less acute settings? A qualitative study. Eur J Emerg Med. 2020 [acceso 01/04/2024];27(1):40-5. Disponible en: https://journals.lww.com/euro-emergencymed/abstract/2020/02000/why_do_parents_present_to_the_paediatric_emergency.11.aspx
Platter MEM, Kurvers RAJ, Janssen L, Verweij MMJ, Barten DG. The impact of an emergency care access point on pediatric attendances at the emergency department: An observational study. Am J Emerg Med. 2020 [acceso 10/04/2024];38(2):191-197. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0735675719300804?via%3Dihub
Egan M, Murar F, Lawrence J, Burd H. Identifying the predictors of avoidable emergency department attendance after contact with the NHS 111 phone service: analysis of 16.6 million calls to 111 in England in 2015-2017. BMJ Open. 2020 [acceso 11/04/2024];10(3). Disponible en: https://bmjopen.bmj.com/content/10/3/e032043.long
Pehlivanturk-Kizilkan M, Ozsezen B, Batu ED. Factors Affecting Nonurgent Pediatric Emergency Department Visits and Parental Emergency Overestimation. Pediatr Emerg Care. 2022 [acceso 08/04/2024];38(6):264-8. Disponible en: https://journals.lww.com/peconline/abstract/2022/06000/factors_affecting_nonurgent_pediatric_emergency.4.aspx
Enlaces refback
- No hay ningún enlace refback.
Copyright (c) 2025 Marcelo Galdos-Bejar, Ivana Belanovic-Ramirez, Alvaro Diaz-Canales, Carlos J. Toro-Huamanchumo, Nilton Yhuri Carreazo
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.
