PMID- 8637274
OWN - NLM
STAT- MEDLINE
DCOM- 19960710
LR  - 20061115
IS  - 0025-7753 (Print)
IS  - 0025-7753 (Linking)
VI  - 106
IP  - 10
DP  - 1996 Mar 16
TI  - [Internal medicine in a group of 52 Spanish hospitals. Analysis of a case series 
      and efficiency].
PG  - 361-7
AB  - BACKGROUND: To analyze the case-mix and efficiency in a group of Services of 
      Internal Medicine (IM) from 52 Spanish hospitals with routinary clinical 
      information system. METHODS: From a total amount of 566,726 discharges during 
      1992, we studied the 71,430 corresponding to IM, analyzing the Minimum Basic Data 
      Set and the Diagnosis-Related Groups (DRG). The hospitals were classified as 
      level A (< 250 beds), B (251-599) and C (600 or over). We analyzed: Major 
      Diagnostic Category (MDC); DRG, raw average length of stay (ALOS); outliers, 
      trimmed ALOS; mortality; case-mix index; performance index; ajusted ALOS (by 
      standard performance and case-mix); associated complications; number of diagnoses 
      per discharge. A Chi-square test was used for qualitative variables and a 
      mean-comparison test (independent data) for the quantitative ones. RESULTS: Among 
      the Internal Medicine Departments, IM was the Service that cared most patients, 
      even more in the small-size hospitals. The most frequent DRG were: chronic 
      obstructive pulmonary disease (COPD) 6.5% (DRG 088); simple pneumonia & pleuresy 
      6.1% (DRGs 089-090); heart failure 5.9% (DRG 127); stroke 4.5% (DRG 014); and 
      angor pectoris 2.4% (DRG 140). The ALOS was shorter in the A-level hospitals 
      (10.1 days) vs. B-level (11.6) and C-level (14.4). However, the trimmed ALOS was 
      more homogeneous (A 8.8; B 9.9; C 11.7). The complexity indexes increased with 
      the hospital level although the performance index also increased. CONCLUSIONS: 
      The IM services provide care for a high percentage of hospital patients, 
      especially in the small-size centers. In these, less complex patients are seen, 
      with decreased comorbidity, complications and mortality and they solve their 
      patients with shorter ALOS than the IM services in the large-size hospitals.
FAU - Diez, A
AU  - Diez A
AD  - Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Universitario 
      del Mar, Barcelona.
FAU - Tomas, R
AU  - Tomas R
FAU - Varela, J
AU  - Varela J
FAU - Casas, M
AU  - Casas M
FAU - Gonzalez-Macias, J
AU  - Gonzalez-Macias J
LA  - spa
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
TT  - La medicina interna en un grupo de 52 hospitales espanoles. Analisis de 
      casuistica y eficiencia.
PL  - Spain
TA  - Med Clin (Barc)
JT  - Medicina clinica
JID - 0376377
SB  - IM
CIN - Med Clin (Barc). 1997 Jan 25;108(3):117-8. PMID: 9064433
CIN - Med Clin (Barc). 1997 Jun 14;109(3):119. PMID: 9289517
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Data Interpretation, Statistical
MH  - *Diagnosis-Related Groups
MH  - *Hospitals/classification/trends
MH  - Humans
MH  - *Internal Medicine
MH  - Length of Stay
MH  - Middle Aged
MH  - Models, Theoretical
MH  - Spain
EDAT- 1996/03/16 00:00
MHDA- 1996/03/16 00:01
CRDT- 1996/03/16 00:00
PHST- 1996/03/16 00:00 [pubmed]
PHST- 1996/03/16 00:01 [medline]
PHST- 1996/03/16 00:00 [entrez]
PST - ppublish
SO  - Med Clin (Barc). 1996 Mar 16;106(10):361-7.