Características de los ingresos hospitalarios de las personas sin hogar en Sevilla
Características de los ingresos hospitalarios de las personas sin hogar en Sevilla
RESUMEN Fundamentos: Las personas sin hogar presentan una mayor morbi-mortalidad que las que sí lo tienen. Este hecho no ha sido investigado suficientemente en España desde la perspectiva de la atención hospitalaria. El objetivo fue conocer las características de las hospitalizaciones de las personas sin hogar en dos hospitales de Sevilla. Métodos: Estudio observacional de 103.802 hospitalizaciones correspondientes a 71.756 personas ingresadas en los Hospitales Virgen del Rocío y Macarena (2013 y 2014) analizadas en función de si las personas ingresadas tenían o no hogar. Se realizó análisis bivariante mediante χ2 y t-Student y análisis multivariante con modelos de regresión logística binomial. Resultados: 163 (0,16%) de las hospitalizaciones correspondieron a personas sin hogar y 103.639 (99,84%) a personas con hogar. La edad media de ingreso de las personas sin hogar fue de 48 años, siendo el 76,5% hombres. La mortalidad intrahospitalaria se produjo a una edad media de 23 años menor que la de las personas con hogar (p=0,009). El 92% de sus ingresos fueron urgentes (p<0,001) y el 10,0% tuvieron altas voluntarias/fugas (p<0,001). La estancia media en las personas sin hogar fue 4,8 días mayor (p=0,001) y sus principales motivos de ingreso fueron enfermedades mentales (27,0%), infecciosas (19,6%) y respiratorias (18,4%). El 83,7% de estas personas presentaron enfermedad mental como comorbilidad y el 77,6% consumía alguna droga, alcohol o tabaco. Conclusiones: Las características de las hospitalizaciones de las personas sin hogar que ingresan en los dos hospitales con mayor actividad asistencial de Sevilla son distintas a las de las personas con hogar. Las personas sin hogar ingresan y fallecen a menor edad. Tanto su patrón de morbilidad como las características de sus hospitalizaciones reflejan su estado vulnerable de salud.
ABSTRACT Background: It is well known from studies in different countries that homeless persons have a higher morbidity and mortality. This fact has not been sufficiently investigated in Spain from the perspective of hospital care. The aim was to determine the characteristics of hospital admissions of homeless persons in Seville. Methods: Observational study of 103,802 hospital admissions of 71,756 patients admitted in the Hospitals "Virgen del Rocío" and "Virgen Macarena" (Seville), in 2013 and 2014. Bivariate analysis were performed using χ2 and t-Student tests and multivariate analysis using binomial logistic regression model. Results: 0.16% (n=163) of admissions were homeless persons and 99.84% (n=103,639) were not. The mean age at admission in homeless patients was 48 years and 76.5% of them were men. Hospital deaths of homeless patients occurred being 23 years younger (p=0.009). 92% of hospital admissions came from emergency departments (p<0.001) and 10.0% of their discharges were against medical advice (p<0.001). The average length of stay was 4.8 days longer in homeless persons (p=0.001) and the most frequent diagnoses on admission were mental (27.0%), infectious (19.6%) and respiratory diseases (18.4%). Mental disorders were present on 83.7% of homeless patients as secondary diagnose and 77.6% referred drugs consumption. Conclusions: Hospital admissions characteristics of homeless persons were particularly different. Homeless patients were hospitalized and died at a younger age than non-homeless patients. The morbidity and mortality of homeless persons reflect their vulnerable health condition.
Homeless persons, Psychotropic drugs, Patient discharge, Alcohol Drinking, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization, Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection, Alta hospitalaria, Estancia hospitalaria, España, Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged, Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain, Uso de tabaco, Ingresos hospitalarios, Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans, Medical Subject Headings::Named Groups::Persons::Age Groups::Adult, Infección, Tuberculosis, Mortality, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality, Medical Subject Headings::Diseases::Respiratory Tract Diseases, Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged, Medical Subject Headings::Psychiatry and Psychology::Mental Disorders, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic Models, Personas sin hogar, HIV, VIH, Medical Subject Headings::Check Tags::Female, Morbilidad, Consumo de bebidas alcohólicas, Hospitals, Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors, Medical Subject Headings::Check Tags::Male, Tobacco use, Psicotrópicos, Spain, Mortalidad, Length of stay, Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Administration::Hospital Departments::Emergency Service, Hospital, Morbidity, Infection, Medical Subject Headings::Named Groups::Persons::Homeless Persons, Medical Subject Headings::Diseases::Substance-Related Disorders
Homeless persons, Psychotropic drugs, Patient discharge, Alcohol Drinking, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization, Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection, Alta hospitalaria, Estancia hospitalaria, España, Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged, Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain, Uso de tabaco, Ingresos hospitalarios, Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans, Medical Subject Headings::Named Groups::Persons::Age Groups::Adult, Infección, Tuberculosis, Mortality, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality, Medical Subject Headings::Diseases::Respiratory Tract Diseases, Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged, Medical Subject Headings::Psychiatry and Psychology::Mental Disorders, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic Models, Personas sin hogar, HIV, VIH, Medical Subject Headings::Check Tags::Female, Morbilidad, Consumo de bebidas alcohólicas, Hospitals, Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors, Medical Subject Headings::Check Tags::Male, Tobacco use, Psicotrópicos, Spain, Mortalidad, Length of stay, Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Administration::Hospital Departments::Emergency Service, Hospital, Morbidity, Infection, Medical Subject Headings::Named Groups::Persons::Homeless Persons, Medical Subject Headings::Diseases::Substance-Related Disorders
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