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Adultos sin seguro que se presentan a los departamentos de emergencias de los Estados Unidos: suposiciones frente a

Manya F Newton¹, Carla C Keirns, Rebecca Cunningham

¹Robert Wood Johnson Clinical Scholars Program, University of Michigan School of Medicine, 1150 W Medical Center Dr, 6312 Medical Science Bldg 1, Ann Arbor, MI 48109-5604, USA. manyan@umich.edu

|October 23, 2008

Resumen

Muchas suposiciones sobre pacientes sin seguro en los departamentos de emergencia (ED) carecen de evidencia. Si bien las personas sin seguro usan ED y carecen de acceso a la atención primaria, no causan principalmente hacinamiento ni buscan atención por conveniencia.

Área de la Ciencia:

Servicios de salud Servicios de salud Investigación Investigación.
Política de salud pública Política de salud pública.
Medicina de emergencia Medicina de emergencia.

Sus antecedentes:

Los departamentos de emergencia (ED) se enfrentan a un aumento en el volumen de pacientes, que a menudo sirven como último recurso para las personas sin seguro.
Las decisiones políticas con respecto a los ED a menudo están influenciadas por suposiciones comunes, pero a menudo no respaldadas, sobre pacientes sin seguro.

Objetivo del estudio:

Evaluar críticamente las suposiciones prevalentes sobre pacientes no asegurados en ED contra la evidencia existente.
Proporcionar una perspectiva basada en la evidencia sobre la utilización de la atención de emergencia por parte de poblaciones sin seguro.

Principales métodos:

Se realizó una búsqueda exhaustiva de la literatura de las bases de datos en proceso de MEDLINE y MEDLINE (1950-2008).
Los criterios de inclusión se centraron en pacientes adultos (18-65 años) no asegurados que reciben atención médica / quirúrgica en entornos de emergencia.
Un enfoque descriptivo cualitativo identificó y analizó los supuestos, con búsquedas de datos posteriores para su validación.

Principales resultados:

De los 127 artículos incluidos, 53 contenían suposiciones sobre pacientes con disfunción eréctil sin seguro.
La evidencia apoya que los pacientes sin seguro usan más ED y carecen de acceso a la atención primaria.
Los datos no respaldan las afirmaciones de que los pacientes sin seguro causan sobrepoblación de ED, presentan afecciones menos agudas o usan ED por conveniencia.

Conclusiones:

Varias creencias generalizadas sobre el uso de los departamentos de emergencia por parte de pacientes sin seguro no están respaldadas por los datos actuales.
Esto pone de relieve la necesidad de una formulación de políticas basada en la evidencia con respecto al acceso a la atención de emergencia para las poblaciones vulnerables.

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