RESUMO
OBJECTIVE: To study the justification of paediatric consultations in the hospital emergency services in line with the diagnosis, the need for further tests not available in primary care (PC), the need for admission or observation and the distance between home and casualty. DESIGN: A descriptive study assessing 2,906 emergency records forms. We used the chi-squared test for the statistical analysis. The extent of the associations was calculated using the odds ratio (OR) calculation. SETTING: Casualty department in the Nuestra Señora de Candelaria Hospital in Santa Cruz de Tenerife. PATIENTS AND OTHER PARTICIPANTS: Those patients between 0 and 14 attended at the casualty department. MEASUREMENTS AND MAIN RESULTS: The 80% of the patients lived closer than 10 kilometres to the hospital. The 39.8% attended because of a trauma. The 55% of attendances were considered unjustified. The fact that 70% of the traumatic injuries required an X-Ray (OR = 7) led to our establishing significant differences (p < 0.0001) between the proportion of justified consultations caused by trauma and by other reasons. The consultations by patients who lived over 10 km from the hospital were significantly more justified (p < 0.0001). CONCLUSIONS: The absence of radiological facilities in primary care emergency services means that patients with traumatic injuries have to attend hospital despite the triviality of the great majority of cases. Closeness to hospital facilities causes not only greater use of these, but a greater number of unjustified attendances.
