Análisis del Uso de un Servicio de Urgencias en un Hospital de Portugal: Un Estudio Observacional
DOI:
https://doi.org/10.12707/RVI25.30.40250Palabras clave:
servicios médicos de urgencia, triaje, uso excesivo de los servicios de salud, alfabetización en salud, salud digital, acceso a atención primariaResumen
Marco contextual: El servicio de urgencias se enfrenta a una sobrecarga debido al uso excesivo para afecciones no urgentes, por lo que el Sistema de Clasificación de Prioridades de Manchester es essencial para priorizar las atenciones en función de la gravedad clínica.
Objetivo: Analizar el uso que hacen los usuarios del servicio de urgencias de un hospital de la región norte de Portugal.
Metodología: Estudio observacional. Los datos se obtuvieron consultando los registros clínicos en el sistema de información “SClínico” a todos los usuarios admitidos en el servicio de urgencias, en el periodo comprendido entre el 1 de enero de 2019 y el 31 de diciembre de 2022.
Resultados: En 2020, las admisiones disminuyeron (108 120), pero en 2022 superaron el período prepandémico (170 013). Alrededor del 40 % de los usuarios fueron casos no urgentes, principalmente por dolores leves (55,3 %).
Conclusión: La elevada proporción de casos no urgentes refuerza la necesidad de promover la alfabetización sanitaria y fortalecer la atención primaria para reducir el uso excesivo del servicio de urgencias.
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Andika, P. J., Safaruddin, Christina, T. Y., Baso, Y. S., & Utami, S. (2025). Effectiveness of the Manchester triage system in the emergency department: A literature review. BIO Web of Conferences, 152, 01004. https://doi.org/10.1051/bioconf/202515201004
Barbosa, J., Organista, D., Rodrigues, T., Matos, A. F., Barardo, A., Escoval, A., Bárbara, C. & Rodrigues, F. (2024). Profile of emergency department overuse in hospitalized patients with pulmonary disease and its impact on mortality. Pulmonology, 30(6), 586-594. https://doi.org/10.1016/j.pulmoe.2023.01.005
Brazão, M. L., & Baptista, A. M. (2022). Queremos mesmo melhorar as urgências em Portugal? Lusíadas Scientific Journal, 3(3), 7-11. https://doi.org/10.48687/lsj.130
Coster, J. E., Turner, J. K., Bradbury, D., & Cantrell, A. (2017). Why do people choose emergency and urgent care services? A rapid review utilizing a systematic literature search and narrative synthesis. Academic Emergency Medicine, 24(9), 1137-1149. https://doi.org/10.1111/acem.13220
Dickinson, A., & Joos, S. (2021). Barriers to integration of primary care into emergency care: Experiences in Germany. International Journal of Integrated Care, 21(2), 11. https://doi.org/10.5334/ijic.5442
Dixe, M. A., Passadouro, R., Peralta, T., Ferreira, C., Lourenço, G., & Sousa, P. M. (2018). Determinantes do acesso ao serviço de urgência por utentes não urgentes. Revista de Enfermagem Referência, 4(16), 41-52. https://doi.org/10.12707/RIV17095
European Union. (2025). Complete guide to GDPR compliance. https://gdpr.eu/
Field, A. (2018). Discovering statistics using IBM SPSS statistics (5thed.). Sage edge. Grupo Português de Triagem. (2021). Sistema de Triagem de Manchester. https://www.grupoportuguestriagem.pt/grupo-portugues-triagem/protocolo-triagem-manchester/
Instituto Nacional de Estatística. (2022). Estatísticas de saúde 2020. https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_publicacoes&PUBLICACOESpub_boui=436989156&PUBLICACOESmodo=2
International Council of Nurses. (2022). Nurses: A Voice to Lead Invest in nursing and respect rights to secure global health. https://www.icn.ch/sites/default/files/2023-04/ICN_IND_Toolkit_English_FINAL.pdf
Kessel, R. V., Wong, B. L., Clemens, T., & Brand., H. (2022). Digital health literacy as a super determinant of health: More than simply the sum of its parts. Internet Interventions, 27, 100500. https://doi.org/10.1016/j.invent.2022.100500
Mackway-Jones, K., Marsden, J., & Windle, J. (2023). Emergency triage: Manchester triage group (3rd ed.). Wiley Blackwell. Organization for Economic Co-operation and Development. (2023). Health at a glance 2023: OECD indicators. https://www.oecd.org/content/dam/oecd/en/publications/reports/2023/11/health-at-a-glance-2023_e04f8239/7a7afb35-en.pdf
Pinchbeck, E. W. (2019). Convenient primary care and emergency mhospital utilisation. Journal of Health Economics, 68, 102242. https://doi.org/10.1016/j.jhealeco.2019.102242
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer. Portaria nº 71/2024 da Saúde. (2024). Diário da República: 1.ª Série, n.º 41. https://diariodarepublica.pt/dr/detalhe/portaria/71-2024-853780170
Savioli, G., Ceresa, I. F., Gri, N., Piccini, G. B., Longhitano, Y., Zanza, C., Piccioni, A., Esposito, C., Ricevuti, G., & Bressan, M. A. (2022). Emergency department overcrowding: Understanding the factors to find corresponding solutions. Journal of Personalized Medicine, 12(2), 279. https://doi.org/10.3390/jpm12020279
Shahid, R., Shoker, M., Chu, L. M., Frehlick, R., Ward, H., & Pahwa, P. (2022). Impact of low health literacy on patients’ health outcomes: A multicenter cohort study. BMC Health Services Research, 22, 1148. https://doi.org/10.1186/s12913-022-08527-9
Silva, F. G., Costa, S., Malcata, F., Sá, J., Vasconcelos, R., Cabral, M., Guedes, R., Vilaça, I. M., Guedes, L. P., Ferreira, J., Pereira, N., Pais, J. G., Neves, J., Monteiro, J., Pires, V., Paiva, M., Guimarães, R., Ashrafian, H., Moreira, R., … Araújo, F. (2025). Addressing the overuse of hospital emergency departments in the Portuguese NHS: A new paradigm. Frontiers in Public Health, 12, 1444951. https://doi.org/10.3389/fpubh.2024.1444951
Vainieri, M., Panero, C., & Coletta, L. (2020). Waiting times in emergency departments: A resource allocation or an efficiency issue? BMC Health Services Research, 20, 549. https://doi.org/10.1186/s12913-020-05417-w
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). Strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. BMJ, 335, 806-808. https://doi.org/10.1136/bmj.39335.541782.AD
World Health Organization. (2021). Global patient safety action plan 2021-2030: Towards eliminating avoidable harm in health care. https://iris.who.int/server/api/core/bitstreams/a28c34c0-089c-4f5d-a0b-1-5d9c35a3cd67/content
World Medical Association. (2024). WMA Declaration of Helsinki– Ethical Principles for Medical Research Involving Human Participants. https://www.wma.net/policies-post/wma-declaration-of-helsinki/
