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        "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&#46;</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 &#40;AEP&#41; developed for concurrent review&#46; Two physicians who were not directly involved in admitting the patients performed the review&#46; A logistic regression analysis was performed in order to identify the independent predictors of inappropriate hospital admission&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 633 admissions analyzed&#44; 92&#46;1&#37; &#40;n&#61;583&#41; were appropriate and 7&#46;9&#37; &#40;n&#61;50&#41; were inappropriate&#46; The main reason for considering an admission to be inappropriate was that the patients in question could have been managed as outpatients &#40;70&#37;&#41;&#44; whereas appropriate admissions were most frequently justified by the need for parenteral treatment &#40;76&#46;3&#37;&#41; or respiratory therapy &#40;62&#37;&#41;&#46; In the logistic regression analysis&#44; the variables that were independently associated with inappropriate admission were nonurgent admission &#40;odds ratio&#44; 2&#46;82&#59; 95&#37; confidence interval&#44; 1&#46;28&#8211;6&#46;21&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;01&#41;&#44; and a neoplasia diagnosis as the reason for admission &#40;odds ratio&#44; 8&#46;57&#59; 95&#37; confidence interval&#44; 2&#46;69&#8211;27&#46;24&#59; <span class="elsevierStyleItalic">P</span>&#60;&#46;0005&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The rate of inappropriate hospital admissions was lower than that reported in other studies&#46; Most inappropriate admissions were of patients who could have been managed as outpatients&#46; An admission diagnosis of neoplasm and nonurgent admission were independent predictors of inappropriateness&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar la tasa de inadecuaci&#243;n de ingresos en un servicio de neumolog&#237;a a lo largo de un a&#241;o y conocer las causas que motivan dicha inadecuaci&#243;n&#44; as&#237; como las variables predictoras de &#233;sta&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se analizaron todos los ingresos del Servicio de Neumolog&#237;a del Hospital de Valme durante 2004 aplicando una versi&#243;n concurrente del Appropriateness Evaluation Protocol &#40;AEP&#41;&#46; Realizaron la evaluaci&#243;n 2 facultativos no implicados en el ingreso de los pacientes&#46; Se efectu&#243; un an&#225;lisis de regresi&#243;n log&#237;stica para determinar las variables que predec&#237;an la inadecuaci&#243;n de forma independiente&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se analizaron 633 ingresos&#44; de los que el 92&#44;1&#37; &#40;n &#61; 583&#41; fueron adecuados y el 7&#44;9&#37; &#40;n &#61; 50&#41; inadecuados&#46; La causa principal de inadecuaci&#243;n fue el ingreso de pacientes que podr&#237;an haber sido manejados ambulatoriamente &#40;70&#37;&#41;&#44; mientras que los criterios que con m&#225;s frecuencia justificaron la adecuaci&#243;n del ingreso fueron la necesidad de tratamiento parenteral &#40;76&#44;3&#37;&#41; y las terapias respiratorias &#40;62&#37;&#41;&#46; Las variables que se relacionaron de forma independiente con la inadecuaci&#243;n en la regresi&#243;n log&#237;stica fueron el ingreso no urgente &#40;odds ratio &#61; 2&#44;82&#59; intervalo de confianza del 95&#37;&#44; 1&#44;28&#8211;6&#44;21&#59; p &#61; 0&#44;01&#41; y el diagn&#243;stico de neoplasia como motivo de ingreso &#40;odds ratio &#61; 8&#44;57&#59; intervalo de confianza del 95&#37;&#44; 2&#44;69&#8211;27&#44;24&#59; p &#60; 0&#44;0005&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La tasa de inadecuaci&#243;n de ingresos fue baja en comparaci&#243;n con otros estudios y se debi&#243; sobre todo al ingreso de pacientes que pod&#237;an haber sido manejados ambulatoriamente&#46; La neoplasia como diagn&#243;stico de ingreso y los ingresos no urgentes fueron predictores independientes de inadecuaci&#243;n&#46;</p>"
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Original Articles
Appropriateness of Hospital Admissions to a Pulmonology Department
Francisco Campos Rodrígueza,
Corresponding author
fcamposr@telefonica.net

Correspondence: Dr. F. Campos Rodríguez. Avda. Emilio Lemos, 19, portal 2, 4. E. 41020 Sevilla. España
, Inés de la Cruz Moróna, Luis López Rodríguezb, Araceli Díaz Martínezc, Martín Tejedor Fernándezc, Francisco Muñoz Lucenaa
a Servicio de Neumología, Hospital Universitario de Valme, Sevilla, Spain
b Unidad de Investigación y Formación, Hospital Universitario de Valme, Sevilla, Spain
c Sección de Calidad y Documentación Clínica, Hospital Universitario de Valme, Sevilla, Spain
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        "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&#46;</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 &#40;AEP&#41; developed for concurrent review&#46; Two physicians who were not directly involved in admitting the patients performed the review&#46; A logistic regression analysis was performed in order to identify the independent predictors of inappropriate hospital admission&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 633 admissions analyzed&#44; 92&#46;1&#37; &#40;n&#61;583&#41; were appropriate and 7&#46;9&#37; &#40;n&#61;50&#41; were inappropriate&#46; The main reason for considering an admission to be inappropriate was that the patients in question could have been managed as outpatients &#40;70&#37;&#41;&#44; whereas appropriate admissions were most frequently justified by the need for parenteral treatment &#40;76&#46;3&#37;&#41; or respiratory therapy &#40;62&#37;&#41;&#46; In the logistic regression analysis&#44; the variables that were independently associated with inappropriate admission were nonurgent admission &#40;odds ratio&#44; 2&#46;82&#59; 95&#37; confidence interval&#44; 1&#46;28&#8211;6&#46;21&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;01&#41;&#44; and a neoplasia diagnosis as the reason for admission &#40;odds ratio&#44; 8&#46;57&#59; 95&#37; confidence interval&#44; 2&#46;69&#8211;27&#46;24&#59; <span class="elsevierStyleItalic">P</span>&#60;&#46;0005&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The rate of inappropriate hospital admissions was lower than that reported in other studies&#46; Most inappropriate admissions were of patients who could have been managed as outpatients&#46; An admission diagnosis of neoplasm and nonurgent admission were independent predictors of inappropriateness&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar la tasa de inadecuaci&#243;n de ingresos en un servicio de neumolog&#237;a a lo largo de un a&#241;o y conocer las causas que motivan dicha inadecuaci&#243;n&#44; as&#237; como las variables predictoras de &#233;sta&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se analizaron todos los ingresos del Servicio de Neumolog&#237;a del Hospital de Valme durante 2004 aplicando una versi&#243;n concurrente del Appropriateness Evaluation Protocol &#40;AEP&#41;&#46; Realizaron la evaluaci&#243;n 2 facultativos no implicados en el ingreso de los pacientes&#46; Se efectu&#243; un an&#225;lisis de regresi&#243;n log&#237;stica para determinar las variables que predec&#237;an la inadecuaci&#243;n de forma independiente&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se analizaron 633 ingresos&#44; de los que el 92&#44;1&#37; &#40;n &#61; 583&#41; fueron adecuados y el 7&#44;9&#37; &#40;n &#61; 50&#41; inadecuados&#46; La causa principal de inadecuaci&#243;n fue el ingreso de pacientes que podr&#237;an haber sido manejados ambulatoriamente &#40;70&#37;&#41;&#44; mientras que los criterios que con m&#225;s frecuencia justificaron la adecuaci&#243;n del ingreso fueron la necesidad de tratamiento parenteral &#40;76&#44;3&#37;&#41; y las terapias respiratorias &#40;62&#37;&#41;&#46; Las variables que se relacionaron de forma independiente con la inadecuaci&#243;n en la regresi&#243;n log&#237;stica fueron el ingreso no urgente &#40;odds ratio &#61; 2&#44;82&#59; intervalo de confianza del 95&#37;&#44; 1&#44;28&#8211;6&#44;21&#59; p &#61; 0&#44;01&#41; y el diagn&#243;stico de neoplasia como motivo de ingreso &#40;odds ratio &#61; 8&#44;57&#59; intervalo de confianza del 95&#37;&#44; 2&#44;69&#8211;27&#44;24&#59; p &#60; 0&#44;0005&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La tasa de inadecuaci&#243;n de ingresos fue baja en comparaci&#243;n con otros estudios y se debi&#243; sobre todo al ingreso de pacientes que pod&#237;an haber sido manejados ambulatoriamente&#46; La neoplasia como diagn&#243;stico de ingreso y los ingresos no urgentes fueron predictores independientes de inadecuaci&#243;n&#46;</p>"
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Archivos de Bronconeumología

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