ABSTRACT
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Subject(s)
Humans , Emergency Medical Services/economics , Cost Efficiency Analysis , Cost-Benefit Analysis/methods , Diagnosis-Related Groups/economics , Outpatient Clinics, Hospital/economicsABSTRACT
El presente trabajo expone la informatización de los servicios de enfermería de la Fundación Hospital Calahorra, los aplicativos informáticos implantados, la estrategia para su puesta en marcha, los beneficios, carencias y dificultades que han conllevado (AU)
Subject(s)
Hospital Information Systems , Nursing Services , Computers , SoftwareABSTRACT
Although the Appropriateness Evaluation Protocol (AEP) has been widely used during the past decade, several methodological concerns have not yet been properly resolved, including the possible influence of low completeness of the medical records on the results yielded by the AEP in retrospective studies. We examined medical records for a random sample of 345 patient-days with the AEP, according to a protocol that included several variables potentially related to inappropriateness. The completeness of physician and nursing notes was also assessed. The proportion of inappropriate days of hospitalization was 36.2%. In the crude analysis, significantly higher proportions of inappropriateness were found for lower values of completeness. Factors related to the inappropriateness of stay were summer season, elective admission, no previous admissions, surgical and medical-surgical service in charge, and the day sampled falling within the last third of the hospital stay. Adjustment for the completeness level of medical records did not substantially change the strength of the association between these factors and the inappropriateness of hospital stay. Completeness level itself did not show any significant association with the proportion of inappropriate days in the adjusted analysis.
Subject(s)
Hospitals, University/statistics & numerical data , Length of Stay , Medical Records/standards , Utilization Review/standards , Bias , Health Services Research , Humans , Patient Readmission , Reproducibility of Results , Retrospective Studies , Seasons , SpainABSTRACT
The best way to estimate non response bias and its potential effect in epidemiological research to know the characteristics of non respondents. The purpose of this study is to analyze what characteristics of those who refused to answer telephone and personal interviews in a follow-up study can predict non-response. As part of the Yale Health and Ageing Project, a follow-up study initiated in 1982 in the USA in a population sample of 2.806 over 65 years of age, the influence of several factors in non-response rate for those who refused to answer the interview was analyzed. A total of 21 variables related to demographic, health, and social characteristics were analyzed. The dependent variable was defined as response/non-response to the interviews. The results did not show significant statistical associations. The only factors that showed specific patterns were housing (in both types of interviews), and education level, cognitive status, and physical disability in personal interview in women, with p values for the Odds Ratios between 0.05 and 0.07. In conclusion, most results of this study do not support the findings already published. A disadvantaged sociodemographic situation was not a predictor factor of non-response, except for the education level of women in personal interviews. In relation to health status only a poor cognitive status, as it has been already reported, seems to induce refusal of women to personal interviews.
