title: [Emergency care of patients with upper gastrointestinal bleeding in regional hospitals in Catalonia].
abstract: OBJECTIVE
  To evaluate the resources available in Catalan regional hospitals for the emergency care of upper gastrointestinal hemorrhage.
  
  
  METHODS
  We analyzed a survey sent to 32 hospitals on the availability, composition and resources of a duty endoscopy service for the year 2009.
  
  
  RESULTS
  Responses were obtained from 24 centers, covering 3,954,000 inhabitants. Duty endoscopists were available in 12 hospitals. A total of 1,483,000 inhabitants were unable to access a duty endoscopist in the referral center. Centers with duty endoscopists had more beds and had a larger catchment area. Duty services were composed of 4.5 endoscopists (range 2-11), covering 82.1 (33.2-182.5) duty shifts/year. Seventeen centers reported 1,571 episodes (51%, range: 3-280, 39.68/100,000 inhabitants). Centers with a duty service reported a greater number of cases (76 vs. 43, p=0.047). Centers without this service referred a greater number of patients (147 vs. 17, p=0.001). Patients in the emergency department were under the care of the internal medicine department in four centers, the surgery department in 14 centers and under the care of both departments in six. Admitted patients were under the care of the gastroenterology department in only six hospitals. The most widely used procedures were ligation of varicose bleeding and injection therapies in non-varicose bleeding. Twenty-one percent of centers did not perform combined treatment.
  
  
  CONCLUSIONS
  A significant proportion of the population does not have access to a duty endoscopist in referral centers. Duty shifts represent significant workload in regional hospitals. Coordination among health professionals and centers would allow the efficient application of therapeutic resources and a duty endoscopy service to be established in centers lacking this resource.
authors: Hospital Universitari Sant Joan, Reus, España. fjmartinez@grupsagessa.com
authors: Francisco José Martínez
authors: FJ
authors: Cerezo
authors: Ghassan Mreish
authors: GM
authors: Tatros
authors: Francisco Vida
authors: FV
authors: Mombiela
authors: Albert
authors: A
authors: Tomas
authors: Agueda
authors: A
authors: Abad
authors: Rafael
authors: R
authors: Campo
authors: Joan
authors: J
authors: Saló
authors: Jaume
authors: J
authors: Boadas
authors: Fernando
authors: F
authors: Baños
authors: Joaquim
authors: J
authors: Rigau
authors: Miriam
authors: M
authors: Sabat
authors: Silvia
authors: S
authors: Fàbregas
authors: Lluis
authors: L
authors: Vidal
authors: Montserrat
authors: M
authors: Planella
authors: Josep Maria
authors: JM
authors: Castellví
authors: Josep
authors: J
authors: Giné
authors: Esteban
authors: E
authors: Saperas
authors: Sandra
authors: S
authors: Torra
authors: Antonio J
authors: AJ
authors: Creix
authors: Miquel
authors: M
authors: Torres
authors: Jordi
authors: J
authors: Rey
authors: Virginia
authors: V
authors: García
authors: José Carlos
authors: JC
authors: Laguna
authors: Domingo
authors: D
authors: Pascual
authors: Cristina
authors: C
authors: Manso
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006471:Gastrointestinal Hemorrhage / Q000628:therapy; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D012189:Retrospective Studies; D013030:Spain