Modelo de análisis del uso del laboratorio por los servicios de urgencias hospitalarios basado en el nivel de urgencia según clasificación del paciente por el sistema de triaje estructurado

Objective

The aim of this study is to describe the applicability and the results obtained by applying an analysis model of the use of laboratory diagnostics resources based on the distribution of patients in the emergency department made through the structured triage systems. This model allows studying whether or not they are used efficiently.

Methods

A database was compiled according to the triage level (TL) of the total number of emergency visits in 2017 (185,128) and requests for laboratory analyses in 4 hospitals. The Spanish triage system was used in all the selected cases. Four indicators were designed to link the triage level and the laboratory resources used (the number of required tests, and the relative value units used in each of the triage levels).

Results

When assessing the complexity of the laboratory requests based on the TL, the higher value of the TL (less complex emergency), the low-medium complexity of the requests for laboratory analyses; relative value units consumed for each clustered TL is higher for levels I, II, III 1,104,712.73 (67.68%) compared with the levels IV, V 527,526.92 (32.32%), emphasising the differences between the hospitals on the number of relative value units used in TL IV, V, 46% and 28%. When the number of requests corresponding to TL IV, V have been considered, the range runs from 63.76% to 35.78%.

Conclusions

The use of the resource of laboratory requests from the emergency department as a function of the level of triage, is possible. Results validate the utility of the proposed set of indicators as a management tool.