Inequalities and health: analysis of a model for the management of Latin American users of an emergency department.

BACKGROUND AND OBJECTIVES The number of foreigners using emergency departments has risen in recent years. The aim of this study was to assess the management of Latin American users, above all Ecuadorian, of an emergency departments by analysing the main reasons for access to the emergency departments, the triage codes assigned and the attitudes and behaviours of healthcare personnel towards foreign nationals, particularly those classifiable as foreigners temporarily present. METHODS The management model was examined through the analysis of medical data, field observation and semi-structured interviews conducted in Spanish regarding sociodemographic, socioanthropological and healthcare issues. RESULTS Latin Americans accounted for 7.51% of the total number of users of the emergency departments; 50.91% were classifiable as foreigners temporarily present. The triage codes assigned to these patients have a high percentages of white (19.75%) and green (69.81%) codes. Patients with foreigners temporarily present status showed high rates of requests for prescriptions and examinations (85.19%), gynaecological problems (69.90%), fever (64.04%), abortion/pregnancy-related requests (56.77%) and leave without being seen (63.91%). CONCLUSIONS The study revealed that foreigners temporarily present look to the emergency departments for non-urgent services, as this is the only facility to which they are entitled to refer for medical treatment. This fact underlines the need to reform healthcare legislation in such a way as to entitle every foreigner to be treated by a Family Physician; this would reduce both waiting times in the emergency departments and the irritation of medical personnel who are called upon to deal with non-urgent cases.