Abstract：
UNLABELLED:An inappropriate hospital use, defined as hospital utilization that could have been occurred at a lower attending level or in less time, increases costs, creates inefficient management and influences on attending quality. The objective of this work was to evaluate the appropriateness and inappropriateness of hospital admissions and stays in a district hospital for acute patients as well as causes of such inappropriateness. MATERIAL AND METHODS:Retrospective, descriptive study based on the review of clinical records of patients who required hospital admission. A sample of 378 patients representative of hospitalization for a 18-month period was selected. As measurement instrument the AEP (Appropriateness Evaluation Protocol) was used. This simple method has proved to be of high validity and reliability for the identification of inappropriate hospital use. RESULTS:The percentage of inappropriate hospital admissions detected was 13.8%, whereas the inappropriateness of hospital stays was 33.9%. As for clinical departments, the higher percentage of inappropriateness corresponded to the Traumatology Department (43%). The causes accounting for the inappropriateness of admissions related to the "necessity of admission"; but at a lower level, "diagnostic tests and/or therapy can be made on an outpatient basis" and "premature admission". As for hospital stays, the most common causes were "not rapid discharge", "diagnostic tests pending" and/or "any diagnostic and/or therapeutic procedure can be performed on an outpatient basis". CONCLUSION:The inappropriateness degree of hospital admissions and stays is similar to that observed in other more complex hospitals in our country. The causes underlying this phenomenon are dependent upon physician's decisions and social and public health conditions of the Area.
journal_name
Rev Clin Espjournal_title
Revista clinica espanolaauthors
Mirón Canelo JA,Orosco Pedemonte JA,Alonso Sardón M,Sáenz González MCkeywords:
subject
Has Abstractpub_date
2000-12-01 00:00:00pages
654-8issue
12eissn
0014-2565issn
1578-1860pii
S0014-2565(00)70035-Xjournal_volume
200pub_type
杂志文章abstract：:The therapeutic effect of captopril in treating mild to moderate arterial hypertension has been evaluated in 20 patients. During 15 days patients underwent a washout period. Patients then received a single dose of 50 mg of captopril by mouth per day during 4 weeks. Before and after treatment, blood pressure (BP) was c...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：:Sarcoidosis is a disease which presents important clinical differences according to its geographical distribution. Thus, the objective of this study was to evaluate the epidemiologic, clinical, radiologic, and diagnostic characteristics in a series of 30 sarcoidosis patients in the province of Salamanca (representing ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
abstract：OBJECTIVES:To determine which social and individual factors may predict adherence to medication in patients with more than two chronic symptomatic diseases (polypathological patients) under polypharmacy. METHODS:Cross-sectional observational study. In a primary care area assigned to our teaching hospital 265 patients ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2009.11.015
更新日期：2010-05-01 00:00:00
abstract：:Antibodies (type IgG) against the A 60 antigen (Mycobacterium bovis, BCG) and an antigen of Mycobacterium tuberculosis were studied by ELISA in 79 patients with not tuberculous disease: 16 lung carcinoma, 16 hepatic cirrhosis and 47 patients with pulmonary disease. 59.5% and 50.6% of the patients showed antibodies aga...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to determine the prognostic factors in relationship to evolution to death of bacteremia-fungemia (BF) episodes occurred in 1986 and to compare them with the results obtained ten years later in 1996. PATIENTS AND METHODS:Prospective study of all BF episodes observed at Hospital...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(01)70765-5
更新日期：2001-03-01 00:00:00
abstract：:The limitation of the therapeutic effort (LTE) consists in not applying extraordinary or disproportionate measures for therapeutic purposes that are proposed for a patient with poor life prognosis and/or poor quality of life. There are two types. The first is to not initiate certain measures or to withdraw them when t...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2011.04.016
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:In the last decades, variations have been described in the epidemiology of lung cancer. In our study, we have analyzed if changes have occurred in the epidemiology and survival of lung cancer. PATIENTS AND METHODS:All the cases with the diagnosis of lung cancer having cytohistological confirma...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2011.06.004
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Since June 2016, there have been outbreaks of hepatitis A in various European countries, mainly affecting men who have sex with men (MSM). The aim of this study was to assess their clinical and epidemiological impact in Cantabria, Spain. MATERIAL AND METHODS:We retrospectively collected all c...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2019.08.005
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVES:To assess the routine indication of chest roentgenogram after thoracentesis in function of iatrogenic pneumothorax causation, following a procedure protocol. PATIENTS AND METHODS:Prospective study of 104 consecutive thoracentesis procedures performed in 76 patients. The procedure was protocolized and after ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13044921
更新日期：2003-03-01 00:00:00
abstract：:Psychology shows that what is free is poorly valued. Free of cost national health systems may become blocked due to misuse and may even become unfeasible. Copayment already exist in Spain. It was introduced in pharmaceutical prescriptions as a solidarity measure. This copayment has generated abuses. Its introduction h...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2012.05.011
更新日期：2012-10-01 00:00:00
abstract：OBJECTIVES:We evaluated the effect of an intervention on certain quality indicators employed for improving the treatment of hospital hyperglycemia. MATERIAL AND METHODS:A multicenter cross-sectional study was conducted on patients with hyperglycemia hospitalized in the internal medicine departments of 44 hospitals eva...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2016.05.006
更新日期：2016-10-01 00:00:00
abstract：OBJECTIVE:To determine the primary drug resistance (PDR) of Mycobacterium tuberculosis in ten hospitals in the Castile-León Community for a five-year period (1991-1995), in a sanitary area with almost two millions of inhabitants. MATERIAL AND METHODS:The sensitivity of 825 strains of Mycobacterium tuberculosis to anti...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1999-03-01 00:00:00
abstract：:Hereditary hemorrhagic telangiectasia (HHT) is a hereditary dominant autosoma clinical entity characterized by repeated hemorrhages (being epistaxis the more frequent) and telangiectasia in skin, mucosa and internal organs. Incidence in Europe is 1,2 per 100,000 pop. We discuss the experience of an Internal Medicine D...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-10-01 00:00:00
abstract：UNLABELLED:The objective of surgical treatment in ulcerative colitis (UC) and Crohn's disease (CD) differs. Surgery in UC is more aggressive and potentially curative whereas in CD it is more conservative and palliative. OBJECTIVE:To assess the opinion of patients with inflammatory bowel disease who underwent surgery i...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(00)70698-9
更新日期：2000-09-01 00:00:00
abstract：OBJECTIVE:To report the clinical and epidemiologic characteristics of 19 patients diagnosed of tularemia at our hospital following an epidemic outbreak occurred in our health area. METHODS:Retrospective analysis of clinical records of patients admitted to our hospital who were examined at the Infectious Diseases Clini...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(01)70854-5
更新日期：2001-07-01 00:00:00
abstract：:Medical emergencies involving patients with Human Immunodeficiency Virus (HIV) infection comprise an increasing number of the total hospitalary consults and contribute to their overflow. In order to evaluate possible alternative solutions to this problem, we performed a retrospective study of urgent medical consults b...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：INTRODUCTION:The use of bone marrow transplantation (BMT) in leukemia treatment is associated with high early morbid-mortality rates. Therefore, to identify morbid-mortality risk factors in this setting can be useful to improve therapeutic ratio. METHODS:We studied 15 variables in 46 patients with chronic myeloid leuk...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1994-08-01 00:00:00
abstract：:Thirty-eight hepatitis B virus (HBV) carriers, AgHBs and anti-HBe positive, with histologic diagnosis of chronic hepatitis have been periodically revised for three years. Three of them were homosexuals. Fourteen patients presented reactivation of viral replication characterized by the appearance in serum of HBV-DNA an...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：OBJECTIVE:To know the prevalence of adrenal insufficiency (AI) in our patients with acquired immunodeficiency syndrome (AIDS) and to compare the clinical manifestations with those reported in previous series in the literature. PATIENTS AND METHODS:Retrospective study with review of clinical records of patients with AI...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1998-02-01 00:00:00
abstract：:An open and multicentric study was conducted with 66 patients with mild to severe diastolic arterial hypertension and echocardiographic left ventricular hypertrophy, the evolution of diastolic function, by means of doppler transmitral flow echocardiography, under treatment with ramipril, an angiotensin converting enzy...
journal_title：Revista clinica espanola
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：1998-01-01 00:00:00
abstract：:A case is presented of Cushing's syndrome due to macronodular bilateral adrenal hyperplasia which is ACTH-independent as was demonstrated by the undetectable basal and after stimulation with metoprolol ACTH plasma levels. High cortisol levels is associated in this patient with empty sella turcica and anterior panhypop...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:Ogilvie's syndrome (OS) is a clinical condiction with the symptoms, signs and radiological appearances of acute bowell obstruction but without any apparent mechanical cause. Diagnosis and treatment are often delayed and many patients are still inappropriately managed which in turn results in an increase in morbidity a...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：:Blood pressure (BP) control is inadequate among treated hypertensive patients in Spain. Control rates are lower than 40% of all treated patients and the cause of this problem is multifactorial. Despite the fact that possible solutions to this problem have been repeatedly suggested by expert groups along the last 10 ye...
journal_title：Revista clinica espanola
pub_type： 共识发展会议,杂志文章
doi：10.1157/13094902
更新日期：2006-11-01 00:00:00
abstract：OBJECTIVE:To prospectively and comparatively study the usefulness of urine (viruria) and blood (antigenemia pp65 and culture) (viremia) for the diagnosis of cytomegalovirus (CMV) infection in renal transplant (RT) recipients. MATERIAL AND METHODS:All RT recipients at our hospital were studied from January 1995 to Dece...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:Clinical findings and response to treatment in four cases with plasma cell leukemia (PCL) out of 152 patients of multiple myeloma diagnosed at the Hospital La Paz from 1969 to 1988 are studied. Three of the four plasma cell leukemia cases presented a primary form, and one a secondary form. Our cases had a lower incide...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1991-11-01 00:00:00
abstract：:A retrospective study is discussed, in which the disorder of pancreatic enzymes in hospitalized patients because of an acute infectious gastroenteritis is analyzed. Of 30 cases, 15 showed a raise in lipase levels, being over 1,000 IU in five of them. There was no associated raise in amylase levels. Patients with high ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-10-01 00:00:00
abstract：:Non insulin antidiabetic drugs are widely used in patients with type 2 diabetes. However, the drugs' effect in terms of reducing cardiovascular risk has been the subject of controversy. In 2008, based on the evidence of cardiovascular risk resulting from the use of a number of non insulin antidiabetic drugs, the US Fo...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2017.02.007
更新日期：2017-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:The aging population is resulting in an increasing number of patients with multiple diseases that require treatment by various specialties. We examined the evolution of consultations and of the percentage of patients treated by several medical specialties. METHODS:We analysed internal medicine...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2019.03.005
更新日期：2019-12-01 00:00:00
abstract：:We have reviewed the clinical histories of 1,815 immunocompromised patients seen in "La Paz Hospital" over a period of 6 years, in order to study the incidence and clinical forms of tuberculosis (TB) in this group of patients. We have distributed the patients into three groups: Group A: 1,372 patients with neoplasia, ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1989-04-01 00:00:00
abstract：:Thirty-nine percent (33/83) of patients in this study present affective disorders in the chronic phase of ischemic cerebral vascular disease (ICV). The incidence of depression reaches its maximum in atherothrombotic infarcts (52%, 15/29) and in infarcts of cardiac embolic origin (71%, 5/7), and its minimum in lacunar ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
