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Vol. 88. Num. 6.01 June 2018
Pages 299-356
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Vol. 88. Num. 6.01 June 2018
Pages 299-356
Original Article
DOI: 10.1016/j.anpede.2017.06.004
Influence of demographic changes on the number of visits to hospital emergency departments: 13 years’ experience
Influencia de los cambios demográficos en la frecuentación de urgencias hospitalarias: 13 años de experiencia
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José Lorenzo Guerra Dieza,
Corresponding author
jguerra@humv.es

Corresponding author.
, Luis Gaite Pindadob, Cristina Álvarez Álvareza, María Teresa Leonardo Cabelloa, Lino Álvarez Grandac, María Jesús Cabero Pérezd
a Urgencias de Pediatría, Hospital Marqués de Valdecilla, Santander, Spain
b Unidad de Evaluación, Servicio de Psiquiatría, Hospital Marqués de Valdecilla, Santander, Spain
c Servicio de Pediatría, Hospital Marqués de Valdecilla, Santander, Spain
d Sección de Pediatría, Hospital Marqués de Valdecilla, Santander, Spain
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Tables (4)
Table 1. Changes in paediatric emergency department (PED) utilisation and the paediatric population in the 2001–2013 period.
Table 2. Annual changes in the number of paediatric emergency department (PED) visits in Cantabria (overall and by age group).
Table 3. Annual changes in the paediatric population of Cantabria (overall and by age group).
Table 4. Evolution by year of the number of emergency department visits per 10000 inhabitants.
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Abstract
Objective

The aim of the present study is to describe the trend in volume and age-specific rates in visits to the paediatric emergency department of a university teaching hospital in Cantabria (Spain) from January 2001 to December 2013, and evaluate the influence of population growth on emergency department use.

Material and methods

A retrospective study was conducted to analyze all emergency department visits over a 13 year period. Simple and polynomial linear regressions were used to assess the relationship between population size and emergency department attendance rates across 2 age groups (0–2 and 3–14 years).

Results

From 2001 to 2013, attendance in the emergency department increased by 14.1%, whereas the paediatric population rose by 26.3%. Rates of presentation per head of population were greatest among those aged <3 years: 1.48 (95% CI 1.40 to 1.56) vs. 0.46 (95% CI 0.44 to 0.48) for the older age group (P<.01). A significant regression equation was found (F[1,11]=11.2, P<.05) with an R2=0.50, showing that population growth produces a continuous rise in the emergency department visits for those aged <3 years. However, ED presentations of patients aged 3–14 years fit a quadratic regression model (R2=0.48, F[2,10]=4.6, P<.05) so increases in population rise ED presentations until an inflection point, after which increases in population will decrease ED visits.

Conclusions

Those aged 0–2 years presented a steady increase in ED visits related to population growth, whereas children aged 3–14 years experienced a “saturation of the demand” and a reduction in ED presentations.

Keywords:
Emergency department
Use
Paediatric patients
Paediatric care
Resumen
Objetivo

Este estudio evalúa la influencia del crecimiento de la población en la utilización del Servicio de Urgencias Pediátricas de un hospital universitario de Cantabria (España) entre enero de 2001 y diciembre de 2013.

Material y métodos

Se realizó un estudio retrospectivo de todas las urgencias ocurridas durante 13 años. Se emplean modelos de regresión lineal simple y polinómica para analizar la relación entre la población y la frecuentación en 2 grupos de edad (0-2 y 3-14 años).

Resultados

De 2001 a 2013, las urgencias aumentaron un 14,1% y la población pediátrica un 26,3%. Las tasas de presentación por persona fueron mayores en los menores de 3 años, 1,48 (IC 95% 1,40 a 1,56) frente a 0,46 (IC 95% 0,44 a 0,48) (p<0,01). El modelo de regresión lineal simple muestra que el crecimiento de la población produce un aumento continuo de las urgencias en los menores de 3 años (R2=0,50, F[1,11]=11,2, p<0,05). En pacientes de 3 a 14 años la frecuentación se ajusta a un modelo de regresión cuadrática (R2=0,48, F[2,10]=4.6, p<05) y el incremento de la población aumenta las urgencias hasta alcanzar un punto de inflexión a partir del cual disminuyen.

Conclusiones

El grupo de edad de 0 a 2 años presentó un aumento constante en las urgencias relacionado con el crecimiento de la población, mientras que el grupo de 3 a 14 años experimentó una «saturación de la demanda» y una reducción de las visitas.

Palabras clave:
Urgencias
Utilización
Pacientes pediátricos
Frecuentación

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