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Birinci basamakta acil sağlık hizmetleri: Tanımlayıcı çalışma

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Emergency health care in primary health care settings: a descriptive study

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Sayfa Aralığı:: 
185-192

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Abstract (Original Language): 
Amaç: Acil sağlık hizmetleri birinci basamak sağlık hizmetleri açısından son derece önemlidir. Biz bu çalışmada acil hastaların özelliklerini ve hastaların acil durumlarda nasıl davrandıklarını saptamayı amaçladık. Yöntem: Bu çalışmada Van'da bir üçüncü basamak acil servisine başvuranlar sistematik örnekleme yöntemi ile seçilerek incelendi. Hastaların demografik özellikleri, başvuru şikayetleri, önceki başvuruları, acil durumlardaki sağlık davranışları ve sonlanımları araştırıldı. Başvuru nedenleri ve tanıları Birinci Basamağın Uluslararası Sınıflandırılması'nın Gözden Geçirilmiş ikinci baskısındaki (BBUS-2-G/ICPC-2-R) kodlarla değerlendirildi. Bulgular: Toplam 190 hasta incelendi, 45 (BBUS-2-G/ICPC-2-R) şikayet kodu kullandı. En sık kullanılanlar genel/belirsiz (A) ve sindirim sistemi (D) başlıkları idi. Acil servise başvuran 37 hasta ( % 1 9 . 5 ) ayaktan tedavi edilmişti. Hastaların % 2 2 . 1 ' i acil servise gelmeden bir sağlık ocağına başvurmuştu. Acil servise gelmeden sağlık ocağına başvuran hastalar arasında en sık görülen yakınmalar ateş, bayılma, karın ağrısı, yan/koltuk altı yakınması, göğüs ağ¬ rısı, konvülsiyon ve sıyrık/kesikti. Sonuç: Bölgemizde sevk zinciri olmamasına rağmen acil durumlarda birinci basamak sağlık kuruluşlarına başvurulmaktadır. Özellikle çocuk hastaların aile hekimlerine mesai dışı saatlerde muayene için getirilmesi beklenebilir. Bölgemizde görülen damdan düşme ve hayvan toslaması gibi yakınmalar BBUS-2-G/ICPC-2-R sı¬ nıflamasında yer almıyordu. Birinci basamakta kullanılan uluslara¬ rası sınıflamaların ulusal özelliklere göre gözden geçirilmesi gere¬ kir.
Abstract (2. Language): 
Objective: Emergency health care is an important part o f primary care health care settings. We aimed t o determine patient's characteristics w i t h urgent problems and h o w they behave in emer¬ gency situations. Methods: Patients selected w i t h a systematically sampling method f r om a tertiary emergency clinic in Van were evaluated. Data about demographics, reasons f o r encounter, previous admis¬ sions, actions in emergency situations and outcomes were explored. Complaints and diagnoses were evaluated according to the codes in the International Classification of Primary Care Revised Second Edition (ICPC-2-R). Results: We surveyed 190 patients. In t o t a l , 45 ICPC-2-R symp¬ t om and complaints codes were used. The most frequent com¬ plaints were seen in t h e sections general (A) and digestive (D). In the emergency clinic 37 patients ( 1 9 . 5 % ) were treated ambulatorily. Patients contacted a primary health care facility in 2 2 . 1 % before encountering the emergency clinic. Among these, fever, unconsciousness, stomach ache, auxiliary complaints, chest ache, convulsion and graze/cut were t h e most frequently observed com¬ plaints. Conclusions: Although no referral requirement exists in our region, patients choose t o contact primary health care facilities in urgent situations. Family physicians should expect visits especially f r om children in out-of-hours. Regional complaints like falling f r om the roof or animal butt could not be f o u n d in t h e ICPC-2-R. International disease classifications should be revised according to national features
DOI: 
doi:10.2399/tahd.08.185

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