Caracterización de los traslados médicos no regulados desde diferentes instituciones prestadoras de salud hacia el Hospital Pablo Tobón Uribe de Medellín, en el año 2017

Jaime Andrés Giraldo Hoyos, Tatiana Arroyave Peña, Andrés Felipe Naranjo, Yeimy Katherine Lopera
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Abstract

Objectives: Unregulated transfers are those in which patients are reassigned to more complex healthcare providers (IPS) in search of a resource that is not available. The service is usually required with urgency due to administrative or patient reasons, thus omitting the regular remission procedure. The main objective is to establish the reason why non-regulated transfers are made to an institution of high complexity. Likewise, we seek to describe the clinical characteristics of these patients, the type of transfer, administrative aspects, the patients’ final disposition, and the resources used. Methodology: A descriptive observational study was conducted, where the databases of the patients admitted in 2017 as unregulated transfers to a high complexity hospital in the city of Medellin were reviewed. Results: The main reason for transfer to institutions of high complexity is the patient’s life risk in 49% followed by the lack of resources in 42%, where the medical expert was the main resource used (34%). Patients with a medical diagnosis are the most frequent cause of transfer. Most unregulated transfers come from low and medium complexity (96%). Regarding the final disposition of the patients, 63% are discharged and 13% die in the institution. Conclusions: There are no current literature or objective studies of unregulated transfers that show us precise data and reasons why these take place. It is frequently assumed that they occur due to administrative procedures, but it is the patient’s life risk that leads the medical personnel to move in search of a more complex resource.
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2017年从不同卫生机构向medellin的Pablo tobon Uribe医院进行的不受管制的医疗转诊的特点
目的:不受管制的转移是指患者被重新分配到更复杂的医疗保健提供者(IPS),以寻找无法获得的资源。由于行政或患者原因,通常需要紧急服务,因此省略了常规的缓解程序。主要目标是确定为什么向高度复杂的机构进行不受监管的转移的原因。同样,我们试图描述这些患者的临床特征,转移类型,管理方面,患者的最终处置和使用的资源。方法:进行了一项描述性观察性研究,对2017年不受监管转入麦德林市一家高复杂性医院的患者数据库进行了审查。结果:转到高复杂性机构的主要原因是患者的生命风险(49%),其次是缺乏资源(42%),其中医学专家是主要资源(34%)。有医学诊断的患者是最常见的转移原因。大多数不受管制的转移来自中低复杂性(96%)。关于患者的最终处置,63%的患者出院,13%的患者在该机构死亡。结论:目前没有文献或客观研究向我们展示了不受管制的转移的精确数据和发生原因。人们通常认为,这是由于行政程序而发生的,但正是患者的生命风险导致医务人员转向寻找更复杂的资源。
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