Caseload profile in emergency services: sentinel events for monitoring primary health care

The study's hypothesis was that certain disease entities treated in emergency services, based on the sentinel event concept, are related to flaws in primary care and can be used to develop an indicator for monitoring such care. Quantitative and qualitative data were used on previously selected occurrences treated in the emergency department. Using triangulation of methods, the differences were verified in the frequencies of these occurrences between the areas of patients' residence/primary care units and the motivations leading them to seek the emergency department. Distribution of the frequency of these events varied from 30% to 42.8%, according to the area of residence/ primary care unit (chi(2) = 9.19 and p = 0.027). The interviews suggested the existence of causality between the reason stated for seeking the emergency service and the performance of the primary care units. In conclusion: (1) the frequency of the selected occurrences was influenced by the area of residence/ location of the primary care unit; (2) this influence results partially from the primary care performance; and (3) the study instrument is simple and can help local administrators monitor the daily performance of primary care services.