Document 0181
 DOCN  M95B0181
 TI    [The demand for emergency medical care by the prison population]
 DT    9511
 AU    Miret C; Miro O; Pedrol E; Gomez-Angelats E; Casademont J; Camp J; Milla
       J; Urbano-Marquez A; Servicio de Medicina Interna General, Hospital
       Clinic i; Provincial, Barcelona.
 SO    An Med Interna. 1995 Apr;12(4):175-81. Unique Identifier : AIDSLINE
       MED/95345353
 AB    BACKGROUND: Urgent medical claim from recluse population shows some
       special traits due to firstly, the reclusion situation itself and the
       high prevalence of certain diseases in this population, as the
       infections ones, such as HIV infection, hepatitis B and tuberculosis.
       Moreover, emergency rooms constitute for this patients, a common
       previous admission place. Thus, a high and a complex medical care claim
       must be expected from this population in hospital emergency rooms.
       METHODS: Consultations from ill prisoners examined in emergency room of
       Hospital Clinic Internal Medicine department during 1993, were checked:
       Age, sex, date, time of visit, serology and HIV risk factor, stage
       infection among positive HIV subjects, cause of complaint. age o
       symptomatology, number and the kind of complementary examinations done,
       the consulting time, the diagnosis and its link to the HIV infections,
       the consulting recurrence, and its relation with the initial cause, and
       the patient final destiny. RESULTS: 394 patients, from 598 who
       consulted, were visited (1.8% total consultings). The mean age was 32.4
       years and 92% were men. A 68% (268 patients) realized that had HIV
       infection, and among these, a 37% (99 patients) were AIDS. The most
       frequent cause of complaint were related to respiratory, digestive,
       neurologic and non foci fever, which caused the higher number of
       admissions. The tuberculosis diagnosis was done in 39 patients (9.9%).
       Sixty wine patients discharged from hospital on first examination came
       again one or more times to the emergency room because of the same
       complaint. The number of complementary examinations done was 1,370 (a
       mean of 2.4 per visit), and were significantly higher among the HIV
       patients than in negative or unknown (p < 0.001). The overall admissions
       average was 37%, which increased to 71% among patients visited
       repeatedly. The HIV recluse patients required admission in the 46.3% of
       visits, and the HIV negative ones, in the 20.6% (p < 0.001). The
       duration of the visit among the patients that were discharged was 4
       hours and 54 minutes. CONCLUSION: Recluse population generates an
       important urgent medical care claim. The number of admissions among this
       population is elevated and higher than the respective to the general
       one, related to the age. This high number of consulting, the increased
       number of admissions and the complex assistance (high number of
       complementary examinations that often requires high technology, and the
       repetitive urgent visits, etc.), are caused, mainly by the high
       prevalence of HIV infections among this population.
 DE    Adolescence  Adult  Aged  Aged, 80 and over  Chi-Square Distribution
       Confidence Intervals  Emergency Service, Hospital/STATISTICS & NUMER
       DATA/*UTILIZATION  English Abstract  Female  *Health Services Needs and
       Demand/STATISTICS & NUMER DATA  Hospital Bed Capacity, 500 and over
       Hospitals, General/STATISTICS & NUMER DATA/UTILIZATION  Human  HIV
       Seropositivity/EPIDEMIOLOGY  HIV-1/IMMUNOLOGY  Male  Middle Age
       *Prisoners/STATISTICS & NUMER DATA  Referral and Consultation/STATISTICS
       & NUMER DATA/UTILIZATION  Retrospective Studies  Spain/EPIDEMIOLOGY
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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