ABSTRACT
Objetivo: Buscar elementos comparativos para el control de calidad en unidades de cirugía mayor ambulatoria (CMA). Método: Estudio descriptivo comparativo del índice de ambulatorización (IA) y el índice de sustitución (IS) en el Servicio de Cirugía del Hospital Santa Cristina, de Madrid (España), respecto a indicadores clave (IC) del Sistema Nacional de Salud (SNS). Resultados: Se analizaron 7817 procedimientos de CMA (entre 2006 y 2014) y se obtuvo un IA anual medio del 54%, superior (p <0,0001) al IC «Porcentaje de ambulatorización quirúrgica». Igualmente, la ambulatorización herniaria (media 72%) superó al IC nacional (p <0,0001), mientras que el IS «Hemorroidectomía» (media 33,6%) fue claramente inferior (p <0,0001). Conclusiones: Los IC del SNS son útiles y han permitido determinar un buen desarrollo en la ambulatorización global y de hernia, existiendo oportunidades de mejora en hemorroidectomía. Debe cuidarse su recogida, sin incluir cirugías menores, y su utilidad aumentaría si se ofrecieran datos desglosados por especialidades y complejidad
Objective: To find comparative elements for quality control in major ambulatory surgery (MAS) units. Method: Descriptive and comparative study of the Ambulatory Care Index (AI) and Substitution Index (SI) in the Santa Cristina Hospital Surgery Service (Madrid, Spain) compared to Key Indicators (KI) of the National Health Service (NHS). Results: 7,817 MAS procedures (between 2006 and 2014) were analysed. The average annual AI was 54%, higher (p <0.0001) than «ambulatory surgery» KI. The hernia outpatient procedures (average 72%) were also superior to the national KI (p <0.0001), but ambulatory haemorrhoidectomy (average 33.6%) was clearly lower (p <0.0001). Conclusions: KI of the NHS are useful and allow to establish a proper development in the global AI and hernia outpatient surgery with opportunities for improvement in haemorrhoidectomy. Their collection should be careful, not including minor surgeries. Also, their usefulness could be increased if data was broken down by speciality and by complexity
Subject(s)
Humans , Quality Indicators, Health Care/trends , Ambulatory Surgical Procedures/statistics & numerical data , Efficiency, Organizational/trends , Epidemiology, Descriptive , Postoperative Complications/epidemiology , Herniorrhaphy/statistics & numerical data , Hemorrhoidectomy/statistics & numerical dataABSTRACT
OBJECTIVE: To find comparative elements for quality control in major ambulatory surgery (MAS) units. METHOD: Descriptive and comparative study of the Ambulatory Care Index (AI) and Substitution Index (SI) in the Santa Cristina Hospital Surgery Service (Madrid, Spain) compared to Key Indicators (KI) of the National Health Service (NHS). RESULTS: 7,817 MAS procedures (between 2006 and 2014) were analysed. The average annual AI was 54%, higher (p <0.0001) than «ambulatory surgery¼ KI. The hernia outpatient procedures (average 72%) were also superior to the national KI (p <0.0001), but ambulatory haemorrhoidectomy (average 33.6%) was clearly lower (p <0.0001). CONCLUSIONS: KI of the NHS are useful and allow to establish a proper development in the global AI and hernia outpatient surgery with opportunities for improvement in haemorrhoidectomy. Their collection should be careful, not including minor surgeries. Also, their usefulness could be increased if data was broken down by speciality and by complexity.
