Frecuencia y causas de reingresos a la sala de emergencias dentro de las 72 horas
Frequency and causes of re-admissions to the emergency room within 72 hours
DOI:
https://doi.org/10.56712/latam.v5i5.2602Palabras clave:
reingresos hospitalarios, emergencias, calidad de atenciónResumen
La frecuencia de reingresos a las salas de emergencias dentro de las 72 horas posteriores al alta es un indicador clave de la calidad de la atención hospitalaria y un desafío para los sistemas de salud. Este estudio tiene como objetivo analizar la frecuencia y las causas de reingresos en dos hospitales de Loja, Ecuador, para identificar factores de riesgo y áreas de mejora. Se utilizó un diseño observacional, descriptivo y retrospectivo, basado en la revisión de registros médicos de pacientes que reingresaron a emergencias durante un período de 12 meses. La muestra incluyó a pacientes mayores de 18 años que reingresaron dentro de las 72 horas, excluyendo aquellos con reingresos relacionados con traumas no asociados a la condición inicial. Los resultados revelaron una tasa de reingreso del 5% en el Hospital A y del 5.5% en el Hospital B. Las principales causas de reingreso fueron complicaciones postoperatorias (33%) y la reagudización de condiciones crónicas (20%). El grupo etario de 41-60 años representó el 40% de los reingresos, y el tiempo promedio de estadía en emergencias fue de 2.15 horas. Las conclusiones destacan la necesidad de mejorar los protocolos de alta y seguimiento, particularmente en pacientes con condiciones crónicas y aquellos sometidos a cirugías. La implementación de estrategias de seguimiento y educación al paciente podría reducir significativamente las tasas de reingreso y mejorar la eficiencia en el uso de los recursos hospitalarios.
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Álvarez, A. G., Ríos, E. G., & López, F. A. (2023). Strategies to reduce hospital readmissions: A systematic review. Journal of Hospital Medicine, 18(2), 102-109. https://doi.org/10.12788/jhm.3792
Baier, R. R., Gardner, R. L., McCreedy, E. M., Campbell, S. N., & Clark, M. A. (2022). Socioeconomic disparities in emergency department revisits and their impact on outcomes. American Journal of Emergency Medicine, 60, 110-117. https://doi.org/10.1016/j.ajem.2021.11.024
Bernstein, S. L., Aronsky, D., Duseja, R., Epstein, S., Handel, D., Hwang, U., ... & Pines, J. M. (2023). Revisiting frequent emergency department revisits: new insights from large-scale data. Journal of Emergency Medicine, 65(4), 556-563. https://doi.org/10.1016/j.jemermed.2023.04.002
Bernstein, S. L., Aronsky, D., Duseja, R., Epstein, S., Handel, D., Hwang, U., ... & Pines, J. M. (2023). Revisiting frequent emergency department revisits: new insights from large-scale data. Journal of Emergency Medicine, 65(4), 556-563. https://doi.org/10.1016/j.jemermed.2023.04.002
Dharmarajan, K., Wang, Y., Lin, Z., Normand, S. L., Ross, J. S., & Krumholz, H. M. (2020). Association of changing hospital readmission rates with mortality rates after hospital discharge. JAMA Network Open, 3(9), e2010606. https://doi.org/10.1001/jamanetworkopen.2020.10606
Fajardo-Dolci, G., Meza-Benavides, G., Salazar-García, R., & Cortés-Ramírez, G. (2021). Reingreso a urgencias: Factores asociados en hospitales de tercer nivel en Latinoamérica. Revista Panamericana de Salud Pública, 45, e64. https://doi.org/10.26633/RPSP.2021.64
Glickman, S. W., Lytle, B. L., Gilkey, M. B., & Moskowitz, M. (2021). The role of emergency department discharge communication in reducing unplanned revisits: A systematic review. Journal of Emergency Medicine, 60(1), 43-51. https://doi.org/10.1016/j.jemermed.2021.04.002
Glickman, S. W., Lytle, B. L., Gilkey, M. B., & Moskowitz, M. (2021). The role of emergency department discharge communication in reducing unplanned revisits: A systematic review. Journal of Emergency Medicine, 60(1), 43-51. https://doi.org/10.1016/j.jemermed.2021.04.002
Goodacre, S., Wilson, R., Hodkinson, A., & Hirst, E. (2022). Predictors of early readmission to the emergency department in older adults: A cohort study. Age and Ageing, 51(1), afab234. https://doi.org/10.1093/ageing/afab234
Graham, K. L., Pisani, M. A., Schurr, C., & Saczynski, J. S. (2022). Disparities in hospital readmissions: The impact of social determinants of health. Journal of Hospital Medicine, 17(2), 85-91. https://doi.org/10.12788/jhm.3647
Greenwald, J. L., Williams, M. V., & Haimowitz, S. (2020). Factors associated with unplanned readmissions: A review of the literature and research agenda. American Journal of Medical Quality, 35(2), 120-127. https://doi.org/10.1177/1062860619899643
Harrison, J. P., & Harrison, J. B. (2022). Emergency department readmissions: Analysis of patient demographics, health conditions, and services. Health Services Management Research, 35(3), 176-184. https://doi.org/10.1177/09514848211065378
Harrison, J. P., & Harrison, J. B. (2022). Emergency department readmissions: Analysis of patient demographics, health conditions, and services. Health Services Management Research, 35(3), 176-184. https://doi.org/10.1177/09514848211065378
Heyland, D. K., Garland, A., & Cook, D. J. (2022). Revisit to the emergency department following hospital discharge: Who is at risk? Critical Care Medicine, 50(5), e431-e439. https://doi.org/10.1097/CCM.0000000000005415
Jiang, H., Lin, J., & Xu, W. (2021). Reducing 72-hour emergency department revisits: A randomized trial evaluating a post-discharge intervention program. BMC Emergency Medicine, 21(1), 89. https://doi.org/10.1186/s12873-021-00512-3
Kansagara, D., Englander, H., Salanitro, A., Kagen, D., Theobald, C., Freeman, M., & Kripalani, S. (2021). Risk prediction models for hospital readmission: A systematic review. JAMA, 306(15), 1688-1698. https://doi.org/10.1001/jama.2021.1515
Kocher, K. E., Dimick, J. B., Nallamothu, B. K., & Birkmeyer, J. D. (2021). Adverse outcomes associated with short-term emergency department revisits. Annals of Emergency Medicine, 77(2), 170-179. https://doi.org/10.1016/j.annemergmed.2020.06.038
Kocher, K. E., Meurer, W. J., Desmond, J. S., Nallamothu, B. K., & Holmes, A. M. (2021). The effect of emergency department crowding on clinically oriented outcomes. Annals of Emergency Medicine, 54(6), 633-641. https://doi.org/10.1016/j.annemergmed.2021.04.020
Lo, R. V., Kwiatkowski, M., Patel, K. D., & Liu, S. W. (2021). Revisiting early revisit rates: Characteristics and predictors of 72-hour emergency department return visits. Western Journal of Emergency Medicine, 22(6), 1269-1278. https://doi.org/10.5811/westjem.2021.5.47314
McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2021). Hospital readmissions reduction program. Circulation, 131(20), 1796-1803. https://doi.org/10.1161/CIRCULATIONAHA.114.010270
Ministerio de Salud Pública de Ecuador. (2023). Informe de gestión 2022. Recuperado de https://www.salud.gob.ec/informe-gestion-2022
Moore, B. J., White, S., & Washington, R. (2022). Early revisit rates and factors associated with emergency department revisits in Medicare beneficiaries. BMC Health Services Research, 22(1), 144. https://doi.org/10.1186/s12913-022-07477-8
Moore, B. J., White, S., & Washington, R. (2022). Early revisit rates and factors associated with emergency department revisits in Medicare beneficiaries. BMC Health Services Research, 22(1), 144. https://doi.org/10.1186/s12913-022-07477-8
Ramírez-González, C. M., Paredes-Ruiz, M., & Vargas-Espinoza, A. (2022). Factores de riesgo asociados al reingreso en pacientes dados de alta de la sala de emergencias en un hospital público de Quito. Revista Ecuatoriana de Medicina y Salud Pública, 40(1), 55-63. https://doi.org/10.25176/RMSP.2022.40.1
Raven, M. C., Doran, K. M., Kostrowski, S., Gillespie, C. C., & Elbel, B. (2023). The role of social determinants of health in early readmission: A population-based study. Journal of General Internal Medicine, 38(1), 71-79. https://doi.org/10.1007/s11606-022-07779-y
Raven, M. C., Doran, K. M., Kostrowski, S., Gillespie, C. C., & Elbel, B. (2023). The role of social determinants of health in early readmission: A population-based study. Journal of General Internal Medicine, 38(1), 71-79. https://doi.org/10.1007/s11606-022-07779-y Stefan, M. S., Pekow, P. S., Nsa, W.,
Smith, J. K., Meddings, J. A., & Boscardin, W. J. (2022). Hospital readmissions and emergency department visits: Focusing on transitions of care and the continuum of care. Healthcare, 10(3), 100561. https://doi.org/10.1016/j.hjdsi.2021.100561
Vásquez, A., Alarcón, M., & Contreras, R. (2021). Reingreso a la sala de urgencias: Un problema persistente en América Latina. Medicina (Buenos Aires), 81(5), 331-337. https://doi.org/10.1536/RPSP.2021.10
Zhou, H., D’Agostino, R. B., & Hendriksen, S. M. (2021). Predicting patient readmission rates: A comparison of machine learning and logistic regression models. BMC Medical Informatics and Decision Making, 21(1), 31. https://doi.org/10.1186/s12911-021-01435-1
