Originales
Adecuación de los ingresos hospitalarios en un servicio de neumología
Appropriateness of Hospital Admissions to a Pulmonology Department
Francisco Campos Rodrígueza,
, Inés de la Cruz Moróna, Luis López Rodríguezb, Araceli Díaz Martínezc, Martín Tejedor Fernándezc, Francisco Muñoz Lucenaa
Corresponding author
fcamposr@telefonica.net
Correspondencia: Dr. F. Campos Rodríguez. Avda. Emilio Lemos, 19, portal 2, 4.° E. 41020 Sevilla. España.
Correspondencia: Dr. F. Campos Rodríguez. Avda. Emilio Lemos, 19, portal 2, 4.° E. 41020 Sevilla. España.
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Hospital Universitario de Valme. Sevilla. España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Investigación y Formación. Hospital Universitario de Valme. Sevilla. España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Sección de Calidad y Documentación Clínica. Hospital Universitario de Valme. Sevilla. España" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. F. Campos Rodríguez. Avda. Emilio Lemos, 19, portal 2, 4.° E. 41020 Sevilla. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Appropriateness of Hospital Admissions to a Pulmonology Department" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-12-04" "fechaAceptado" => "2006-02-07" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153151" "palabras" => array:3 [ 0 => "Adecuación" 1 => "Ingresos hospitalarios" 2 => "Appropriateness Evaluation Protocol" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153150" "palabras" => array:3 [ 0 => "Appropriateness" 1 => "Hospital admissions" 2 => "Appropriateness evaluation protocol" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar la tasa de inadecuación de ingresos en un servicio de neumología a lo largo de un año y conocer las causas que motivan dicha inadecuación, así como las variables predictoras de ésta.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se analizaron todos los ingresos del Servicio de Neumología del Hospital de Valme durante 2004 aplicando una versión concurrente del Appropriateness Evaluation Protocol (AEP). Realizaron la evaluación 2 facultativos no implicados en el ingreso de los pacientes. Se efectuó un análisis de regresión logística para determiner las variables que predecían la inadecuación de forma independiente.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se analizaron 633 ingresos, de los que el 92,1% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>583) fueron adecuados y el 7,9% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>50) inadecuados. La causa principal de inadecuación fue el ingreso de pacientes que podrían haber sido manejados ambulatoriamente (70%), mientras que los criterios que con más frecuencia justificaron la adecuación del ingreso fueron la necesidad de tratamiento parenteral (76,3%) y las terapias respiratorias (62%). Las variables que se relacionaron de forma independiente con la inadecuación en la regresión logística fueron el ingreso no urgente (<span class="elsevierStyleItalic">odds ratio</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2,82; intervalo de confianza del 95%, 1,28-6,21; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,01) y el diagnóstico de neoplasia como motivo de ingreso (<span class="elsevierStyleItalic">odds ratio</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8,57; intervalo de confianza del 95%, 2,69-27,24; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,0005).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La tasa de inadecuación de ingresos fue baja en comparación con otros estudios y se debió sobre todo al ingreso de pacientes que podían haber sido manejados ambulatoriamente. La neoplasia como diagnóstico de ingreso y los ingresos no urgentes fueron predictores independientes de inadecuación.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To analyze the rate of inappropriate admissions to a pulmonology department over the period of a year and to establish the reasons for such admission and predictors.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">All 2004 admissions to the pulmonology department of the Hospital de Valme were analyzed using a version of the Appropriateness Evaluation Protocol (AEP) developed for concurrent review. Two physicians who were not directly involved in admitting the patients performed the review. A logistic regression analysis was performed in order to identify the independent predictors of inappropriate hospital admission.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 633 admissions analyzed, 92.1% (n=583) were appropriate and 7.9% (n=50) were inappropriate. The main reason for considering an admission to be inappropriate was that the patients in question could have been managed as outpatients (70%), whereas appropriate admissions were most frequently justified by the need for parenteral treatment (76.3%) or respiratory therapy (62%). In the logistic regression analysis, the variables that were independently associated with inappropriate admission were nonurgent admission (odds ratio, 2.82; 95% confidence interval, 1.28-6.21; <span class="elsevierStyleItalic">P</span>=.01), and a neoplasia diagnosis as the reason for admission (odds ratio, 8.57; 95% confidence interval, 2.69-27.24; <span class="elsevierStyleItalic">P</span><.0005).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The rate of inappropriate hospital admissions was lower than that reported in other studies. Most inappropriate admissions were of patients who could have been managed as outpatients. An admission diagnosis of neoplasm and nonurgent admission were independent predictors of inappropriateness.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Estudio financiado por la Consejería de Salud de la Junta de Andalucía mediante el proyecto de investigación expediente 287/04.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identificación del uso inapropiado de la hospitalización: la búsqueda de la eficiencia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Peiró Moreno" 1 => "E. 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Article information
ISSN: 03002896Original language: Spanish
DOI:10.1157/13092414
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| 2020 April | 29 | 22 | 51 |
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| 2018 November | 27 | 19 | 46 |
| 2018 October | 33 | 11 | 44 |
| 2018 September | 27 | 6 | 33 |
| 2018 July | 1 | 0 | 1 |
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| 2018 May | 13 | 1 | 14 |
| 2018 April | 5 | 8 | 13 |
| 2018 March | 6 | 6 | 12 |
| 2018 February | 8 | 8 | 16 |
| 2018 January | 7 | 8 | 15 |
| 2017 December | 12 | 15 | 27 |
| 2017 November | 7 | 9 | 16 |
| 2017 October | 13 | 13 | 26 |
| 2017 September | 9 | 5 | 14 |
| 2017 August | 11 | 13 | 24 |
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| 2017 May | 8 | 9 | 17 |
| 2017 April | 11 | 11 | 22 |
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| 2017 January | 5 | 6 | 11 |
| 2016 December | 14 | 13 | 27 |
| 2016 November | 24 | 14 | 38 |
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| 2016 August | 21 | 7 | 28 |
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| 2016 June | 32 | 9 | 41 |
| 2016 May | 22 | 4 | 26 |
| 2016 April | 30 | 2 | 32 |
| 2016 March | 13 | 3 | 16 |
| 2016 February | 18 | 2 | 20 |
| 2016 January | 27 | 16 | 43 |
| 2015 December | 30 | 10 | 40 |
| 2015 November | 24 | 4 | 28 |
| 2015 October | 94 | 1 | 95 |
| 2015 September | 73 | 0 | 73 |
| 2015 August | 68 | 0 | 68 |
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| 2015 June | 50 | 0 | 50 |
| 2015 May | 83 | 0 | 83 |
| 2015 April | 56 | 0 | 56 |
| 2015 March | 62 | 0 | 62 |
| 2015 February | 43 | 0 | 43 |
| 2015 January | 49 | 0 | 49 |
| 2014 December | 51 | 0 | 51 |
| 2014 November | 69 | 0 | 69 |
| 2014 October | 91 | 0 | 91 |
| 2014 September | 57 | 0 | 57 |
| 2014 August | 79 | 0 | 79 |
| 2014 July | 61 | 0 | 61 |
| 2014 June | 68 | 0 | 68 |
| 2014 May | 92 | 0 | 92 |
| 2014 April | 100 | 0 | 100 |
| 2014 March | 81 | 0 | 81 |
| 2014 February | 79 | 0 | 79 |
| 2014 January | 79 | 0 | 79 |
| 2013 December | 78 | 0 | 78 |
| 2013 November | 52 | 0 | 52 |
| 2013 October | 68 | 0 | 68 |
| 2013 September | 65 | 0 | 65 |
| 2013 August | 73 | 0 | 73 |
| 2013 July | 83 | 0 | 83 |
| 2013 June | 69 | 0 | 69 |
| 2013 May | 74 | 0 | 74 |
| 2013 April | 41 | 0 | 41 |
| 2013 March | 10 | 0 | 10 |
| 2000 January | 2586 | 0 | 2586 |
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