APH 2002, 60, 59-68:

Public health practices experiences.
Les urgences dans un hopital regional.
Profil épidémiologique et étude de la satisfaction des usagers/patients.
Service régional des urgences de Kébili - Tunisie.

A. Chetoui and J.P. Papart


Background: the regional emergency service in Kebili — Tunisia is often inappropriately used. Consequently a number of problems have occurred due to service overcrowding by non-urgent cases and the negative impact in terms of quality and pertinence of care.

Methods: the survey lasted a whole week, 24/24 h; two questionnaires were used. The first was divided into two parts. One part, filled out at the reception of the patients, included the following items: identification, social insurance, and the symptoms/reasons for consultating. The second part was filled out by the physicians of the service to evaluate the degree of urgency of the case, and the medical conclusion. The other questionnaire was given to the patient and/or their parents to collect data about their degree of satisfaction.

Results: 94,6% of the samples — 205 patients — were autoreferred. 1/3 of the traumatic emergencies were classified as true urgent cases. More than half of all the medical emergencies didn’t need hospital-based equipment. 35,6% of the cases presented non frequent medical problems and only the quarter of them were true medical emergency. 53% of the cases classified as justified and non justified emergencies, wouldn’t probably be admitted and treated at the service if the primary care were of a higher quality.

Conclusion: the majority of the cases admitted at the regional emer­gency service wouldn’t be so if the emergency medical specialisation were individualised as an entire hospital department. Furthermore, we should emphasise the effort made in the medical education of the population and in the development of the primary care system.