[Evaluation of the organisation of care for patients without appointment].
OBJECTIVE
To calculate the improvement achieved in organising care for patients without appointments after introducing corrective measures. Second, to study the reasons for consultation, the duration of the symptoms because of which consultations without appointment take place, and the assessment by health personnel of the relevance of the emergency.


METHODS
Before-and-after study.Setting. Health Area 9, urban health centre, Leganés, Madrid.


METHODS
All the patients attending consecutively without appointment in the study periods (assessment: November 1998; reassessment: November-December 1999).


RESULTS
588 patients were included in the assessment and 562 in the reassessment. They belonged to general practice and paediatrics. 5 quality criteria were set: recording of basic details; recording of reason for consultation; assessment in under ten minutes; attempt at prior appointment; and record in the clinical notes. As there were no references in the bibliography, they were agreed by the team. After corrective measures were taken, all criteria except the fourth improved significantly. Nonetheless, the previously set norm was only achieved in the second. The professionals thought 27% of the consultations without appointment in paediatrics were urgent, and 30% in general medicine. Mean duration of symptoms in non-urgent pathologies was 1.5 days in paediatrics and 13.4 in general medicine. The most common reasons for consultation were prescriptions (20%) in general medicine and digestive pathology (20.4%) in paediatrics.


CONCLUSIONS
Setting up an improvement cycle at our health centre managed to raise the quality of care given to patients without appointment, although there are still some facets that could be improved so as to reach, at least, the standards set.
Vítores Picón
M P
MP
EAP. Los Pedroches, Leganés, Madrid, Spain.
Cortés Durán
P M
PM
Fernández Girón
M
M
Torres Romo
L
L
Tomey Torcal
I
I
Iradier Barrio
D
D
Cazallas Díaz
E
E
León García
A
A
D000328:Adult; D001071:Appointments and Schedules; D002648:Child; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D013030:Spain; D019037:Urban Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data
Evaluación de la organización en la atención a pacientes sin cita.