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Appropriateness of Hospital Admissions to a Pulmonology Department
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Castañar Jover, Francisco Javier Muñoz Gutiérrez, Luis García Arangüena, Miguel Ángel Alonso, M. del Carmen Montero Martínez, Jesús Allende González, Ignacio Sánchez Hernández" "autores" => array:12 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "Julio Sánchez" "apellidos" => "de Cos Escuín" ] 1 => array:2 [ "nombre" => "Luis Miravet" "apellidos" => "Sorribes" ] 2 => array:2 [ "nombre" => "José Abal" "apellidos" => "Arca" ] 3 => array:2 [ "nombre" => "Ana Núñez" "apellidos" => "Ares" ] 4 => array:2 [ "nombre" => "Jesús Hernández" "apellidos" => "Hernández" ] 5 => array:2 [ "nombre" => "Ana M." "apellidos" => "Castañar Jover" ] 6 => array:2 [ "nombre" => "Francisco Javier" "apellidos" => "Muñoz Gutiérrez" ] 7 => array:2 [ "nombre" => "Luis García" "apellidos" => "Arangüena" ] 8 => array:2 [ "nombre" => "Miguel Ángel" "apellidos" => "Alonso" ] 9 => array:2 [ "nombre" => "M. del Carmen Montero" "apellidos" => "Martínez" ] 10 => array:2 [ "nombre" => "Jesús Allende" "apellidos" => "González" ] 11 => array:2 [ "nombre" => "Ignacio Sánchez" "apellidos" => "Hernández" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906605673?idApp=UINPBA00003Z" "url" => "/15792129/0000004200000009/v1_201305150254/S1579212906605673/v1_201305150254/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S157921290660565X" "issn" => "15792129" "doi" => "10.1016/S1579-2129(06)60565-X" "estado" => "S300" "fechaPublicacion" => "2006-09-01" "aid" => "60565" "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2006;42:434-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2489 "formatos" => array:3 [ "EPUB" => 93 "HTML" => 1842 "PDF" => 554 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Functional Status and Survival in Patients With Chronic Obstructive Pulmonary Disease Following Pulmonary Rehabilitation" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "434" "paginaFinal" => "439" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Victorina López Varela, Turquesa Anido, María Larrosa" "autores" => array:3 [ 0 => array:3 [ "preGrado" => "Dra." "nombre" => "María Victorina" "apellidos" => "López Varela" ] 1 => array:2 [ "nombre" => "Turquesa" "apellidos" => "Anido" ] 2 => array:2 [ "nombre" => "María" "apellidos" => "Larrosa" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921290660565X?idApp=UINPBA00003Z" "url" => "/15792129/0000004200000009/v1_201305150254/S157921290660565X/v1_201305150254/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Appropriateness of Hospital Admissions to a Pulmonology Department" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "440" "paginaFinal" => "445" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco Campos Rodríguez, Inés de la Cruz Morón, Luis López Rodríguez, Araceli Díaz Martínez, Martín Tejedor Fernández, Francisco Muñoz Lucena" "autores" => array:6 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "Francisco Campos" "apellidos" => "Rodríguez" "email" => array:1 [ 0 => "fcamposr@telefonica.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Inés" "apellidos" => "de la Cruz Morón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "Luis López" "apellidos" => "Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "Araceli Díaz" "apellidos" => "Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 4 => array:3 [ "nombre" => "Martín" "apellidos" => "Tejedor Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 5 => array:3 [ "nombre" => "Francisco" "apellidos" => "Muñoz Lucena" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario de Valme, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Investigación y Formación, Hospital Universitario de Valme, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Sección de Calidad y Documentación Clínica, Hospital Universitario de Valme, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. F. Campos Rodríguez. Avda. Emilio Lemos, 19, portal 2, 4. E. 41020 Sevilla. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-12-04" "fechaAceptado" => "2006-02-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154535" "palabras" => array:3 [ 0 => "Appropriateness" 1 => "Hospital admissions" 2 => "Appropriateness evaluation protocol" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154536" "palabras" => array:3 [ 0 => "Adecuación" 1 => "Ingresos hospitalarios" 2 => "Appropriateness Evaluation Protocol" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "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>" ] "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 determinar 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 = 583) fueron adecuados y el 7,9% (n = 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 (odds ratio = 2,82; intervalo de confianza del 95%, 1,28–6,21; p = 0,01) y el diagnóstico de neoplasia como motivo de ingreso (odds ratio = 8,57; intervalo de confianza del 95%, 2,69–27,24; p < 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>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was funded by the Consejería de Salud de la Junta de Andalucía under Research Project No. 287/04.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "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 => "Peiró Moreno S" 1 => "Portella E" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "1994" "volumen" => "103" "paginaInicial" => "65" "paginaFinal" => "71" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Métodos de revisión de utilización de recursos: limitaciones" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Lorenzo S" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "1996" "volumen" => "107" "paginaInicial" => "22" "paginaFinal" => "25" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adecuación y utilidad del ingreso hospitalario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Ollero M" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2001" "volumen" => "116" "paginaInicial" => "655" "paginaFinal" => "657" "itemHostRev" => array:3 [ "pii" => "S1130634308759427" "estado" => "S300" "issn" => "11306343" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An overview of Spanish studies on appropriateness of hospital use" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Lorenzo S" 1 => "Sunol R" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Qual Health Care" "fecha" => "1995" "volumen" => "7" "paginaInicial" => "213" "paginaFinal" => "218" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8595457" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adecuación de la hospitalización en una unidad de estancia corta de un hospital universitario. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 3 | 7 |
| 2024 October | 47 | 21 | 68 |
| 2024 September | 27 | 16 | 43 |
| 2024 August | 37 | 29 | 66 |
| 2024 July | 23 | 25 | 48 |
| 2024 June | 36 | 19 | 55 |
| 2024 May | 34 | 36 | 70 |
| 2024 April | 18 | 22 | 40 |
| 2024 March | 18 | 18 | 36 |
| 2024 February | 22 | 22 | 44 |
| 2023 March | 1 | 3 | 4 |
| 2023 February | 10 | 15 | 25 |
| 2023 January | 14 | 24 | 38 |
| 2022 December | 16 | 19 | 35 |
| 2022 November | 22 | 16 | 38 |
| 2022 October | 20 | 31 | 51 |
| 2022 September | 12 | 21 | 33 |
| 2022 August | 14 | 30 | 44 |
| 2022 July | 19 | 39 | 58 |
| 2022 June | 19 | 28 | 47 |
| 2022 May | 15 | 15 | 30 |
| 2022 April | 16 | 27 | 43 |
| 2022 March | 14 | 33 | 47 |
| 2022 February | 17 | 27 | 44 |
| 2022 January | 12 | 30 | 42 |
| 2021 December | 16 | 52 | 68 |
| 2021 November | 21 | 48 | 69 |
| 2021 October | 18 | 56 | 74 |
| 2021 September | 17 | 56 | 73 |
| 2021 August | 13 | 25 | 38 |
| 2021 July | 12 | 26 | 38 |
| 2021 June | 17 | 36 | 53 |
| 2021 May | 10 | 21 | 31 |
| 2021 April | 59 | 39 | 98 |
| 2021 March | 15 | 16 | 31 |
| 2021 February | 12 | 13 | 25 |
| 2021 January | 10 | 7 | 17 |
| 2020 December | 8 | 14 | 22 |
| 2020 November | 9 | 18 | 27 |
| 2020 October | 11 | 10 | 21 |
| 2020 September | 4 | 3 | 7 |
| 2020 August | 7 | 10 | 17 |
| 2020 July | 11 | 17 | 28 |
| 2020 June | 18 | 3 | 21 |
| 2020 May | 13 | 13 | 26 |
| 2020 April | 17 | 12 | 29 |
| 2020 March | 21 | 14 | 35 |
| 2020 February | 19 | 13 | 32 |
| 2020 January | 20 | 16 | 36 |
| 2019 December | 12 | 17 | 29 |
| 2019 November | 11 | 12 | 23 |
| 2019 October | 4 | 8 | 12 |
| 2019 September | 6 | 11 | 17 |
| 2019 August | 13 | 11 | 24 |
| 2019 July | 8 | 14 | 22 |
| 2019 June | 7 | 9 | 16 |
| 2019 May | 14 | 7 | 21 |
| 2019 April | 19 | 17 | 36 |
| 2019 March | 13 | 19 | 32 |
| 2019 February | 11 | 14 | 25 |
| 2019 January | 3 | 10 | 13 |
| 2018 December | 2 | 15 | 17 |
| 2018 November | 33 | 20 | 53 |
| 2018 October | 56 | 16 | 72 |
| 2018 September | 14 | 7 | 21 |
| 2018 May | 10 | 0 | 10 |
| 2018 April | 4 | 5 | 9 |
| 2018 March | 2 | 1 | 3 |
| 2018 February | 10 | 7 | 17 |
| 2018 January | 10 | 9 | 19 |
| 2017 December | 4 | 3 | 7 |
| 2017 November | 6 | 3 | 9 |
| 2017 October | 7 | 6 | 13 |
| 2017 September | 3 | 4 | 7 |
| 2017 August | 6 | 11 | 17 |
| 2017 July | 2 | 2 | 4 |
| 2017 June | 5 | 9 | 14 |
| 2017 May | 8 | 6 | 14 |
| 2017 April | 3 | 4 | 7 |
| 2017 March | 1 | 5 | 6 |
| 2017 February | 3 | 2 | 5 |
| 2017 January | 1 | 2 | 3 |
| 2016 December | 9 | 5 | 14 |
| 2016 November | 13 | 13 | 26 |
| 2016 October | 10 | 12 | 22 |
| 2016 September | 9 | 3 | 12 |
| 2016 August | 8 | 3 | 11 |
| 2016 July | 7 | 0 | 7 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 38 | 6 | 44 |
| 2015 September | 43 | 6 | 49 |
| 2015 August | 39 | 5 | 44 |
| 2015 July | 36 | 8 | 44 |
| 2015 June | 41 | 4 | 45 |
| 2015 May | 38 | 8 | 46 |
| 2015 April | 50 | 7 | 57 |
| 2015 March | 35 | 10 | 45 |
| 2015 February | 29 | 10 | 39 |
| 2015 January | 22 | 4 | 26 |
| 2014 December | 27 | 3 | 30 |
| 2014 November | 27 | 8 | 35 |
| 2014 October | 30 | 9 | 39 |
| 2014 September | 28 | 8 | 36 |
| 2014 August | 32 | 9 | 41 |
| 2014 July | 33 | 8 | 41 |
| 2014 June | 41 | 10 | 51 |
| 2014 May | 57 | 12 | 69 |
| 2014 April | 44 | 11 | 55 |
| 2014 March | 54 | 8 | 62 |
| 2014 February | 50 | 9 | 59 |
| 2014 January | 32 | 6 | 38 |
| 2013 December | 34 | 7 | 41 |
| 2013 November | 31 | 11 | 42 |
| 2013 October | 37 | 9 | 46 |
| 2013 September | 43 | 5 | 48 |
| 2013 August | 34 | 7 | 41 |
| 2013 July | 45 | 12 | 57 |
| 2013 June | 36 | 8 | 44 |
| 2013 May | 30 | 4 | 34 |
| 2013 April | 18 | 6 | 24 |
| 2013 March | 6 | 1 | 7 |
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