A study of the demand for health care in hereditary-metabolic diseases in a Spanish tertiary care hospital
*Correspondencia: Dr. Miguel Lafuente Hidalgo. Sección de Neurometabolismo. Servicio de Pediatría. Hospital Universitario Miguel Servet. Isabel la Católica, 1-3. E-50009 Zaragoza.
E-mail: mlafuenteh@salud.aragon.es
Aim: To determine the characteristics of the demand for health care in hereditary-metabolic diseases in a Spanish tertiary care hospital.
Patients and methods: We conducted a retrospective descriptive study involving a review of the epidemiological data, reasons for visiting, diagnoses and complementary studies of the patients treated by a metabolic disease unit over a period of 6 years and 11 months.
Results: Altogether 1012 patients were evaluated. There was a predominance of males (52%) and of patients under the age of 1 year (42.09%). 71.44% of them were under 6 years old. Approximately half of the patients (50.3%) came from hospitals (wards, outpatients, neonatology, emergency department, neuropaediatrics and intensive care), followed by the neonatal screening programme (20.36%) and primary care (14.82%). The most frequent reasons for visiting and diagnoses can be seen in their respective tables.
Conclusions: The study of the demand for health care in hereditary-metabolic diseases is useful as a means to detect needs in their field and to try to adapt care to meet them. Medical, scientific and social progress makes it necessary to have an expert in metabolism present in reference clinical units. As members of multidisciplinary teams alongside other specialists, they will contribute towards accomplishing a suitable presumptive diagnosis, diagnosis, management and follow-up. It is necessary to keep them constantly up-to-date and ensure adequate training of new experts in metabolism, since this is the best way to deliver optimal care for those with metabolic illnesses, which are usually rare diseases.
Pacientes y métodos Estudio descriptivo retrospectivo en el que se revisan los datos epidemiológicos, los motivos de consulta, los diagnósticos y los estudios complementarios de los pacientes atendidos por la unidad de enfermedades metabólicas durante un período de 6 años y 11 meses.
Resultados Se valoraron un total de 1.012 pacientes. Hay un predominio de varones (52%) y de pacientes menores de 1 año (42,09%). El 71,44% son menores de 6 años. Los pacientes provienen en un 50,3% del ámbito hospitalario (planta, consultas externas, neonatología, urgencias, neuropediatría y cuidados intensivos), seguido del programa de cribado neonatal (20,36%) y de atención primaria (14,82%).
Conclusiones El estudio de la demanda asistencial de las enfermedades metabólico-hereditarias es útil para detectar necesidades en su campo y tratar de adecuar la asistencia a éstas. Los avances médicos, científicos y sociales hacen necesaria la existencia del experto en metabolismo en unidades clínicas de referencia, integrado en equipos multidisciplinares con otros especialistas, para una adecuada sospecha, diagnóstico, manejo y seguimiento. Debe estar en continua actualización y garantizar la adecuada formación de nuevos expertos en metabolismo, la mejor vía para una óptima atención de los pacientes afectados de enfermedades metabólicas, habitualmente enfermedades raras.
