EVOLUTION OF EMERGENCY EXAMINATIONS IN PA TIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION, AT SEVERAL MEDICAL-CARE LEVELS IN THE URBAN AREA OF BARCELONA

Medical emergencies involving patients with Human Immunodeficiency Vir us (HIV) infection comprise an increasing number of the total hospital ary consults and contribute to their overflow. In order to evaluate po ssible alternative solutions to this problem, we performed a retrospec tive study of urgent medical consults by HIV patients at three differe nt levels of medical care (primary assistance, extrahospitalary and ho spitalary emergencies centers) all included in the same urban area of Barcelona. We demostrated a growing excess in hospitalary emergencies, with high requirements of complementary explorations and hospitalary admittances. In the extrahospitalary emergency center, we can observe a progressive increasing of emergency consults, but still reasonable i n number and adequate to the real possibilities of the center. At prim ary care level, HIV patients consulted because of less severe reasons. We conclude that a possible solution in order to decrease the assista nce requirements in the hospitalary emergencies level could be to try to attend these patients in emergency extrahospitalary centers. These centers shoul be technically provided and with a close relationship bo th with the primary assistance care level and with the reference hospi tal.