Resumen

RAMOS, Ana Azevedo et al. Walk-in appointments: a cross-sectional descriptive analysis in a Portuguese family health unit. Rev Port Med Geral Fam [online]. 2018, vol.34, n.6, pp.361-369. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v34i6.12082.

Objectives: Walk-in Appointments (WIA) are fundamental for Primary Healthcare (PHC) and play a vital role towards the efficient management of resources, sustainability and quality of the National Health System (NHS). This study had as main objective to characterise the WIA at Espaço Saúde Family Health Unit (FHU) through the study of a wide set of variables, including reasons for encounter and diagnoses registered in each appointment. Type of study: Cross-sectional, descriptive study Location: Espaço Saúde FHU, ACeS Porto Ocidental, Portugal Population: Patients observed in WIA at Espaço Saúde FHU in January, April, and July 2014. Methods: A set of variables (age, gender, comorbidities, schooling level, work status, family physician, physician that held the appointment, exemption or non-exemption from user fees, total number of appointments that each patient had in 2014, reason for WIA, main diagnosis according to ICPC-2, and referral to the Emergency department / Hospital) were collected via the SClínico® software. Statistical analysis of the data was performed using Microsoft Excel 2015®. Results: A total of 1,310 WIA were performed, representing 41.2 % of the total number of face-to-face appointments. Most patients were female (62.7%, n=821) with an average age of 44.8 years. The most frequent users were those who were professionally active (41.5%, n=544) and exempt from user fees (58.7%, n= 769). The most commonly reported reason for WIA was A62 - Administrative Procedure (6.12%), followed by R05 - Cough (5.35%), and by A31 and W31 - Medical Examination / Partial Health Evaluation (both at 4.97%). The most frequent diagnosis was R74 - Acute Upper Respiratory Infection (6.52%), followed by A98 - Health Maintenance / Prevention (5.71%) and K86 - Hypertension without complications (5.18%). The referral to emergency department occurred in only 22 appointments (1.9%) and referral to Hospital appointment occurred in 78 appointments (6.0%). Conclusions: In addition to the detailed characterization of WIA at the FHU, this study highlights the importance of improving patients’ health literacy, so that they can understand the specific indications that justify a WIA. The results of the study also reinforce the importance of an accurate clinical record that may often be jeopardized by clinicians’ time constraints, limiting not only the adequate follow-up of patient, but also future investigations. A critical analysis of the main reasons for encounter/diagnoses observed in WIA will allow to better manage resources that, together with teamwork, will allow a better provision of care and improve the quality of service delivery in WIA.

Palabras clave : Walk-in Appointments; Medical inter-substitution.

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