Summary
Physical structure, human resources, and health care quality indicators in public hospital emergency departments in the autonomous communities of Madrid and Catalonia: a comparative study
Affiliation of the authors
DOI
Quote
Del Arco Galán C, Rodríguez Miranda B, González Del Castillo J, Ruiz Grinspan M, Carballo C, Bibiano Guillén C, et al. Physical structure, human resources, and health care quality indicators in public hospital emergency departments in the autonomous communities of Madrid and Catalonia: a comparative study. Emergencias. 2017;29:373-83
Summary
Objective.
To compare the general, structural, and organizational characteristics of public hospital emergency departments in the Spanish autonomous communities of Madrid and Catalonia.
Methods.
Descriptive survey-based study covering 3 areas of inquiry: general hospital features (18 questions), structural features of the emergency department (14 questions), and organizational and work-related policies of the emergency department (30 questions). Hospitals were grouped according to complexity: local hospitals (level 1), high-technology
or referral hospitals (levels 2–3).
Results.
We studied 26 hospital departments in Madrid (21, levels 2–3; 5, level 1) and 55 in Catalonia (24, levels 2–3; 31, level 1). Hospitals in Madrid are in newer buildings (P=.002), have more beds on conventional wards and in critical care units (P<.001, both comparisons), are more often affiliated with a university (P<.001), and serve larger populations (P=.027). The emergency departments in Madrid have larger surface areas available for clinical care and more cubicles for preliminary evaluations and observation beds (P=.001, all comparisons). Hospitals in Madrid also attended a larger median number of emergencies (P<.001). More physicians were employed in Catalonia overall, but the numbers of physician- and nurse-hours per hospital were higher in Madrid, where it was more usual for physicians to work exclusively in the emergency department (92.5% in Madrid vs 56.8% in Catalonia, P<.001). However, fewer of theemployed physicians had permanent contracts in Madrid (30.5% vs 75.1% in Catalonia, P<.001). The ratio of resident physicians to staff physicians differs between the 2 communities on afternoon/evening, night, and holiday shifts (3:1 in Madrid; 1:1 in Catalonia).
Conclusions.
The physical and functional structures of hospital emergency departments in the communities of Madrid and Catalonia differ significantly. The differences cannot be attributed exclusively to geographic location.