Objective:

To characterize same-day appointments (SDA) carried out in a Family Health Unit (FHU) over four years, according to the frequency of appointments/diagnosis and the user’s destination.

Study type:

Cross-sectional, descriptive, and analytical study, applied to the clinic.

Location:

FHU Alpha, ACeS Baixo Vouga.

Population: Patients who came to SDA at USF from January-2014 to December-2017.

Methods:

All episodes of SDA over four years (n=25,810) were studied, namely sex, age, the temporal distribution of SDA; frequency of SDA; diagnosis, and destination of patients. A descriptive and inferential analysis was performed with non-parametric tests using the software Statistical Package for the Social Sciences (SPSS®), v. 25.0.

Results:

Of the episodes of SDA, the majority were women (n=15,596, 60.4%, p<0.001), with a median age of 40 years and frequency/person of two episodes in the period described. Most SDAs took place in the first quarter of the year, in January, on Monday, and in the early hours of the day. The most prevalent pathologies in the context of SDA were acute infection of the upper respiratory system (n=3,744, 17.8%), acute tonsillitis (n=1,326, 6.3%), cystitis/urinary infection (n=987, 4.7%), gastroenteritis (n=846, 4.0%) and acute bronchitis/bronchiolitis (n=737, 3.5%). There were significant differences in the referral between the patient’s family doctor and care by another doctor, referring the latter more to the emergency department (p<0.001) and there were no differences regarding the need to call emergency (p=0.417).

Conclusion:

There were differences in health care between family doctors, creating the need for decision algorithms and severity stratification as a strategy to improve accessibility and quality of care provided in primary health care. Health education for patients is a fundamental strategy to work, mostly in the context of acute pathology.

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