Visits to a hospital emergency department, by patient country of origin

Objective: To analyze demographic data and countries of origin of patients attending

the adult emergency department of our hospital over 1 calendar year. To gather

administrative data related to patient visits (hospital admission, type of health-care

coverage, and mean length of stay).

Methods: Data from digital hospital records stored over a period of 1 year were

extracted to compile descriptive statistics on country of origin, decision to admit or

discharge during the visit, and age. Health-care payment schemes and time spent in the

emergency department were also analyzed.

Results: Spanish nationals account for the largest proportion (81.1%) of our assigned

patient population and they also made the largest number of emergency department visits

(73.0%). Patients from Latin America accounted for 10.0% and other European Union

countries for 6.7%. The admission rate was higher for Spanish nationals (15.9%) and

patients from other European Union countries (14.7%); these groups were also the ones

with a higher proportion of patients over 65 years old. After adjustment per 1000

population, however, the admission rate for Spanish nationals fell to third place, below that

of other European nationals and those from the North African coast. Public health

insurance was available for 88.8% of the patients overall and for 93.9% of the Spanish

patients. Private insurance schemes were used by 5.5%; 26% of those patients were from

European Union countries. A total of 1353 emergency patients (1.5%) treated in 2007 had

no health-care coverage. Most of these were from the former Soviet Union or Sub-Saharan

Africa. The average duration of procedures and time spent in the emergency department

overall came to less than 4 hours. Length of time spent on care was mainly related to

disease and specialty. Trauma patients were cared for most rapidly, with no significant

differences associated with country of origin, time spent in the emergency department, or

decision to admit or discharge. The longest stays in the department were for surgical

patients, particularly those with language difficulties.