Background
We aim to determine the association between out and in-hospital factors with time, from the beginning of the symptoms to the surgery, in patients with acute appendicitis treated at Fundación Hospital Pediatrico La Misericordia (HOMI) in Colombia.
Methods
Eleven month prospective cohort study of pediatric patients at HOMI with acute appendicitis diagnosis taken to surgery. Data from the out-of-hospital phase was collected by surveying parents, and the data regarding the in-hospital phase was completed with medical records. We analyzed the association between the time from the beginning of the symptoms to the surgery, and out and in-hospital factors associated with this time using generalized linear models.
Results
Eight hundred three patients were included in the study. Total pre-surgical time was longer in perforated appendicitis (PA) group (2.65 days, standard deviation (SD) 1.88 vs. 2.04 days, SD 1.45) (p < 0.01). Factors associated with longer total and out-of-hospital presurgical times were age under 4 years old, lower socioeconomic status, father as a caregiver, self-medication, and underestimating disease severity.
Conclusions
Out-of-hospital timing determines the longer pre-surgical time in complicated appendicitis. Younger age and lower socioeconomic status affect time significantly. We suggest the implementation of strategies in order to lower prehospital time, rates, and costs of complicated appendicitis.
Para la elaboración de este documento se tienen en cuenta las diferentes conceptualizaciones sobre servicio y lo que de este concepto se desprende (calidad del servicio), realizando un recorrido histórico que posibilite comprender cómo ha sido su evolución y los modelos más utilizados a la hora de evaluar la percepción de la calidad del servicio. Para ello, se lleva a cabo una breve revisión sobre las propuestas conceptuales más difundidas y de mayor impacto en el mundo académico, haciendo especial énfasis en las características que componen dichos modelos, sus diferencias y limitaciones, así como su aplicación en el contexto universitario. Esto, con el objetivo de reconocer que la percepción de la calidad del servicio y sus modelos de evaluación es una muy buena alternativa de gestión organizacional, capaz de generar valor al servicio educativo
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