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Birinci basamakta acil sağlık hizmetleri: Tanımlayıcı çalışma

Emergency health care in primary health care settings: a descriptive study

Journal Name:

  • Türkiye Aile Hekimliği Dergisi

Publication Year:

  • 2008
DOI: 
doi:10.2399/tahd.08.185

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: Emergency health care is an important part o f primary care health care settings. We aimed t o determine patient's characteristics w i t h urgent problems and h o w they behave in emer¬ gency situations. Methods: Patients selected w i t h a systematically sampling method f r om a tertiary emergency clinic in Van were evaluated. Data about demographics, reasons f o r encounter, previous admis¬ sions, actions in emergency situations and outcomes were explored. Complaints and diagnoses were evaluated according to the codes in the International Classification of Primary Care Revised Second Edition (ICPC-2-R). Results: We surveyed 190 patients. In t o t a l , 45 ICPC-2-R symp¬ t om and complaints codes were used. The most frequent com¬ plaints were seen in t h e sections general (A) and digestive (D). In the emergency clinic 37 patients ( 1 9 . 5 % ) were treated ambulatorily. Patients contacted a primary health care facility in 2 2 . 1 % before encountering the emergency clinic. Among these, fever, unconsciousness, stomach ache, auxiliary complaints, chest ache, convulsion and graze/cut were t h e most frequently observed com¬ plaints. Conclusions: Although no referral requirement exists in our region, patients choose t o contact primary health care facilities in urgent situations. Family physicians should expect visits especially f r om children in out-of-hours. Regional complaints like falling f r om the roof or animal butt could not be f o u n d in t h e ICPC-2-R. International disease classifications should be revised according to national features
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Abstract (Original Language): 
Amaç: Acil sağlık hizmetleri birinci basamak sağlık hizmetleri açısından son derece önemlidir. Biz bu çalışmada acil hastaların özelliklerini ve hastaların acil durumlarda nasıl davrandıklarını saptamayı amaçladık. Yöntem: Bu çalışmada Van'da bir üçüncü basamak acil servisine başvuranlar sistematik örnekleme yöntemi ile seçilerek incelendi. Hastaların demografik özellikleri, başvuru şikayetleri, önceki başvuruları, acil durumlardaki sağlık davranışları ve sonlanımları araştırıldı. Başvuru nedenleri ve tanıları Birinci Basamağın Uluslararası Sınıflandırılması'nın Gözden Geçirilmiş ikinci baskısındaki (BBUS-2-G/ICPC-2-R) kodlarla değerlendirildi. Bulgular: Toplam 190 hasta incelendi, 45 (BBUS-2-G/ICPC-2-R) şikayet kodu kullandı. En sık kullanılanlar genel/belirsiz (A) ve sindirim sistemi (D) başlıkları idi. Acil servise başvuran 37 hasta ( % 1 9 . 5 ) ayaktan tedavi edilmişti. Hastaların % 2 2 . 1 ' i acil servise gelmeden bir sağlık ocağına başvurmuştu. Acil servise gelmeden sağlık ocağına başvuran hastalar arasında en sık görülen yakınmalar ateş, bayılma, karın ağrısı, yan/koltuk altı yakınması, göğüs ağ¬ rısı, konvülsiyon ve sıyrık/kesikti. Sonuç: Bölgemizde sevk zinciri olmamasına rağmen acil durumlarda birinci basamak sağlık kuruluşlarına başvurulmaktadır. Özellikle çocuk hastaların aile hekimlerine mesai dışı saatlerde muayene için getirilmesi beklenebilir. Bölgemizde görülen damdan düşme ve hayvan toslaması gibi yakınmalar BBUS-2-G/ICPC-2-R sı¬ nıflamasında yer almıyordu. Birinci basamakta kullanılan uluslara¬ rası sınıflamaların ulusal özelliklere göre gözden geçirilmesi gere¬ kir.
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  • 4
185-192
  • Turkish

REFERENCES

References: 

1. SE, Parker RM, Baker DW, Rask KJ, Williams MV, McNagny. Ambulatory health care use by patients in a public hospital emergency department. J Gen Intern Med 1998; 13: 614-20.
2.
Ail
e Hekimliği Pilot Uygulaması Hakkında Kanun. http://www.samsun.saglik.gov.tr/pdi^ahkanun.pdf (01.08.2008 tarihinde erişilmiştir)
3. Gill JM, Mainous AG 3rd, Nsereko M. The effect of continuity of care on emergency department use. Arch Fam Med 2000; 9: 333-8.
4. Oterino D, Peiro S, Calvo R, Sutil P, Fernandez O, Perez G, Torre P, Lopez M, Sempere T. Accident and emergency department inappropriate utilization. An evaluation with explicit criteria. Gac Sanit 1999; 13: 361-70.
5. Tolhurst HM, Ireland MC, Dickinson JA. Emergency and after hours work performed in country hospitals. Med J Aust 1990; 153: 458-65.
6. Bridges-Webb C, Britt H, Miles D, et al. Morbidity and treatment in general practice in Australia 1990-1991. Med J Aust 1992; 157: 1-53.
7. Johnston CL, Coulthard MG, Schluter PJ, et al. Medical emergencies in general practice in southeast Queensland: prevalence and practice preparedness. Med J Aust 2001; 175: 99-103.
8. Lowe BM, Stephenson M. Are general practitioners really prepared? An audit of emergency equipment in general practice. N Z Med J 1994; 107:
486-7.
9. Eric P Moll van Charant, Pauline CE van Steenwijk-Opdam, Patrick JE Bindels. Out-of-hours demand for GP care and emergency services: patients' choices and referrals by general practitioners and ambulance services. BMC Family Practice 2007, 8: 46.
10.
Saatç
i E, inan M, Akpınar E. Adana'dan bir Aile Hekimliği Örneği. Türk Aile Hek Derg 2006; 10: 20-4.
11.
Ünsa
l A, Çevik AA, Metintaş S, Arslantaş D, inan OÇ. Yaşlı Hastaların Acil Servis Başvuruları. Geriatri 2003; 6: 83-8.
12. Leibowitz R, Day S, Dunt D. A systematic review of the effect of differ¬ent models of after-hours primary medical care services on clinical out¬come, medical workload, and patient and GP satisfaction. Fam Pract 2003;
20: 311-7.
13. Hallam L. Out of hours primary care. BMJ1997; 314: 157-8.
14. Jessopp L, Beck I, Hollins L, ve ark. Changing the pattern out of hours: a survey of general practice cooperatives. BMJ1997; 314: 199-200.
15. Christensen MB, Olesen F. Out of hours service in Denmark: evaluation
five years after reform. BMJ1998; 316: 1502-5.
16. Giesen P, Haandrikman L, Broens S, ve ark. Centrale Huisartsenposten: Wordt de huisarts er beter van? [GP co-operatives: does the general practitioner benefit from them]. Huisarts Wet 2000; 43: 508-10.
17. Uden CJT van, Crebolder HFJM. Does setting up out of hours primary care cooperatives outside a hospital reduce demand for emergency care? Emerg Med J 2004; 21: 722-3.
18. Snooks H, Williams S, Crouch R, ve ark. NHS emergency response to 999 calls: alternatives for cases that are neither life threatening nor seri¬ous. BMJ2002; 325: 330-3.
19. Murphy AW. Inappropriate attenders at accident and emergency depart¬ments. I. Definition, incidence and reasons for attendance. Fam Pract
1998; 15: 23-32.
20. Van Duijn NP, Weert HCPM, van Scholte D, ve ark. Out of hours: pri¬mary care clinic or hospital emergency department? Eur J Gen Pract1998;
4: 68-73.
21. Kulu-Glasgow I, Delnoy D, den Bakker D. Self-referral in a gate keeping system: patients' reasons for skipping the general-practitioner. Health Policy 1998;45:221-38.
22. Murphy AW, Bury G, Plunkett PK, ve ark. Randomised controlled trial of general practitioner versus usual medical care in an urban accident and emergency department: process, outcome and comparative cost. BMJ
1996; 312: 1135-42.
23. Dale J, Lang H, Roberts JA, ve ark. Cost effectiveness of treating primary care patients in accident and emergency: a comparison between general practitioners, senior house officers, and registrars. BMJ1996; 312: 1340¬4.
24. Coleman P, Irons R, Nicholl J. Will alternative immediate care services reduce demands for non-urgent treatment at accident and emergency?
Emerg Med J2001; 18: 482-7.
25. Giesen P, Franssen E, Mokkink H, van den Bosch W, van Vugt A, Grol R. Patients either contacting a general practice cooperative or accident and emergency department out of hours: a comparison. Emerg Med J
2006; 23: 731-4.
26. Rajpar SF, Smith MA, Cooke MW. Study of choice between accident and emergency departments and general practice centres for out of hours pri¬mary care problems J Accid Emerg Med 2000; 17: 18-21.
27. Grol R, Giesen P, Van Uden C. After-hours care in the United Kingdom, Denmark, And the Netherlands: New models. Health Affairs 2006; 25:
1733-7.
28. Richards SH, Pound P, Dickens A, Greco M, Campbell JL. Exploring users' experiences of accessing out-of-hours primary medical care servic¬es. Quality Safety Health Care 2007; 16: 469-77.
29. Leibowitz R, Day S, Dunt D. A systematic review of the effect of differ¬ent models of after-hours primary medical care services on clinical out¬come, medical workload, and patient and GP satisfaction. Family Practice
2003; 20: 311-7.
30. de LS, Minmagh C, Kennedy J, Zeimet M, Bommezijn H, Bryant J. A survey to identify the clinical coding and classification systems currently in use across Europe. Medinfo 2001; 10: 86-9.
31.
Aktür
k Z, Dağdeviren N. Birinci Basamağın Uluslar arası Sınıflaması. Türkiye Aile Hekimleri Uzmanlık Derneği (TAHUD) Yayınları, Ankara,
2006.

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