[Groups of resource utilization in acute care units and average length of stay at geriatrics services]. / Grupos de utilizacion de recursos en Unidades de agudos y media estancia de Servicios de Geriatria.

BACKGROUND: In recent years, Patient Classifications Systems (PCS's) have been implement in Spain for the purpose of gauging the "hospital product". However, the most conventional systems are not very well-suited to the senior citizen population, among whom illness-related disability is a determining factor with regard to explaining the usage of resources and the results of the health care provided. Therefore, the idea was brought forth of implementing a system in units providing senior citizen care which would entail this parameter, that is, the Resource Usage Groups (RUG's), analyzing the characteristics and differences in the RUG-related spread in four Geriatrics Units. METHODS: A cross-sectional study based on consecutive cutoff points in periods longer than the average stay in each unit, the patients admitted in the acute care units and average stay in the Geriatrics Unit of the Hospital Monte Narango (HMN) (n = 318), Hospital Central de la Cruz Roja (HCCR) (n = 384), Hospital General de Guadalajara (HG) (n = 272) and Hospital Virgen del Valle (HVV) (n = 390), with regard to the spread thereof according to the RUG-T18 classification. The possible differences among the hospitals in question were analyzed by means of the chi-square statistical test (SPSS for Windows). RESULTS: For the overall sample, the patients were divided into groups R, S and C of the classification, groups P and B being represented to a very small degree, differences having been found to exist among the different hospitals. Hence, the HCCR is that which handles the largest percentage of patients in the R group (47.64% vs. 23.66% at HMN; 20.57% at HG and 20.53% at HVV) and a smaller percentage of patients in the S Group (3.12% vs. 6.40% at HMN; 9.92% at HG and 9.76% at HVV) and the C Group (48.94% vs. 76.29% at HMN; 66.89% at HG and 68.36% at HVV). Differences were likewise found to exist in the individual analysis for the acute care units and average length of stay. CONCLUSIONS: The resource usage groups can be useful with regard to ascertaining differences in the health care loads in hospital care for senior citizens.

[Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital]. / La urgencia geriátrica frente a la urgencia en la edad adulta: análisis retrospectivo de las urgencias médicas de un hospital general.

The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.