Adecuación de ingresos y estancias hospitalarias en pacientes con hernia inguinal sin complicaciones

Abstract

BACKGROUND: Inguinal hernia uncomplicated in patients aged over 17 years, diagnosis-related group (DRG) 162, generates a substantial number of hospital stays due its high frequency in our country. These stays may not be necessary, and present an important temporal and geographical variability. MATERIAL AND METHODS: We have analyzed a total of 612 days of stay belonging to the 124 admissions codified as DRG 162 during the first quarter of 1993 and 1994, using the "Appropriateness Evaluation Protocol". RESULTS: The overall mean stay of the DRG 162 was 5.0 days (2.3 days of inadequate stay and 2.7 days of clinically necessary stay). The mean stay in 1993, 5.6 days, was higher than the mean stay in 1994, 4.1 days (p = 0.006). The percentage of inappropriate admission was higher in 1993 than in 1994 (33.8% versus 18.9%; p = 0.06). Similarly, the percentage of inappropriate stay was higher in 1993 than in 1994 (46.9% versus 41.9%; p = 0.06). The more frequent reasons of inappropriate admission was premature admission (88.2%) and for the stay was delay in the discharge medical order (33.3%). CONCLUSIONS: The mean stay of DRG 162, as well as the percentage of inadequate stay and admission, has decreased from 1993 to 1994 in our hospital. According to the observed trend, the mean stay is approaching the adequate mean stay for this DRG.