Characterization of night time visits to an after hours care unit in the Bragança district

Abstract

Title: Out of hours clinics characterization at Bragança district. Introduction: In the eighties the first SAPs - Serviços de Atendimento Permanente (out of hours clinics) were created in Portugal. Since then, they have been multiplied in the Primary Care Centres around the country. This emergency health organization has been put in doubt in rural areas, mainly at night period. This study tries to characterize the existing SAPs in Bragança district. Material and Methods: Data was collected from files of patients that attended SAPs admitted from 0:00 to 7:59, in July, August, November and December of 2005. Diagnostics werecodified using ICPC2. SAP attending population duting night period, the way SAP was used, patients admission motive and discharge diagnosis after attendance were characterized. Diagnosis were codified using ICPC2. Results: A global attendance of 1,5 patients per night was observed, varying from 0,5 to 3,8 patients per night in the different SAPs. August was the month with more patients attended. The elderly were the ones that most attended the SAPs. The more frequent reason for admission was emesis, and the traumatic occurrences were the most prevalent diagnosis. It was observed 39,8% real urgent care situations, from which 29% were emergencies and 71% urgent situations. Conclusions: Its concluded that out of hours care is different from daily care analysed in other articles. Real urgent cases were more observed, with significant emergency occurrences. A better pre-hospitalar care is proposed, with an ambulance network linked with hospitals where urgent and emergent conditions can be received. Minor illness and injury can be taken care by out of hours service that would substitute existing SAPs from 20 to 8 hours.