dc.creator | Pacheco, Jorge | |
dc.creator | Cuadrado, Cristóbal | |
dc.creator | Martínez Gutiérrez, María Soledad | |
dc.date.accessioned | 2019-10-30T15:40:24Z | |
dc.date.available | 2019-10-30T15:40:24Z | |
dc.date.created | 2019-10-30T15:40:24Z | |
dc.date.issued | 2019 | |
dc.identifier | Health Policy and Planning, Volumen 34, Issue 3, 2019, Pages 170-177 | |
dc.identifier | 14602237 | |
dc.identifier | 02681080 | |
dc.identifier | 10.1093/heapol/czz023 | |
dc.identifier | https://repositorio.uchile.cl/handle/2250/172615 | |
dc.description.abstract | The aim of this study is to evaluate the impact of urgent care centres' (UCCs) implementation on emergency department (ED) and same-day visits in primary care in a Chilean public healthcare network. Quasi-experimental design study assessing changes in patient visits after UCC implementation in a local health district. Ten family health centres (FHC), nine UCCs and three EDs in the Talcahuano Health District, Chile. A total of 1 603 055 same-day visits to FHC, 1 528 319 visits to UCCs and 1 727 429 visits to EDs, monthly grouped, from 2008 to 2014. Data were obtained from the Monthly Statistical Register Database. We used quasi-experimental methods to evaluate the impact of UCC implementation on ED visits and same-day visits to FHC. We used a difference-indifference analysis with seasonal adjustments to control potential confounders. We used a triple difference model to test for potential short-term effects. We used as an intervention a group of FHCs and EDs that implemented UCCs from 2008 to 2014 and, as a comparison group, the FHCs and EDs that implemented UCCs before that period. We observed a 5.70% (95% CI: -11.05 to -0.35) decrease in the same-day visits rate to FHCs and a 2.69% (95% CI: -3.96 to -1.43) reduction in ED visits after UCC implementation. The negative trend in same-day visits was more pronounced in children and adolescents (-14.18%; 95% CI: -20.10 to -8.25). The negative trend in ED visits was more pronounced in adult (-4.15%; 95% CI: -5.46 to -2.83) and elderly population (-2.24%; 95% CI: -4.00 to -0.48). We also confirmed that our results are not driven by transient short-term effects after the intervention. UCC implementation reduced ED visits. However, they also reduced same-day visits to primary care centres. This could have a negative impact on the quality of primary care provided. | |
dc.language | en | |
dc.publisher | Oxford University Press | |
dc.rights | http://creativecommons.org/licenses/by-nc-nd/3.0/cl/ | |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 Chile | |
dc.source | Health Policy and Planning | |
dc.subject | Acess | |
dc.subject | Emergency services | |
dc.subject | Primary healthcare | |
dc.title | Urgent care centres reduce emergency department and primary care same-day visits: A natural experiment | |
dc.type | Artículos de revistas | |