[Results of hepatobiliary and pancreatic surgery according to DRG in a level 2 hospital surgery department during the years 2005-2006]. / Resultados de la cirugía hepatobiliopancreática en un servicio de cirugía de un hospital de segundo nivel según los GRD durante el bienio 2005-2006.

OBJECTIVE: To assess the results of the hepatobiliary and pancreatic surgery of a surgery department during 2005-2006 using the diagnostic related groups. MATERIALS AND METHOD: The data were obtained from the CMBD-HA of the Catalan Health Service. We assessed the frequency, hospital stay and mortality of the surgical procedures. The results were compared with the 63 public hospitals, and the 8 of them belonging to the Catalan Health Institute. RESULTS: In our area, a clear trend is observed in referrals for certain types of complex procedures on the liver, pancreas and biliary system excluding cholecystectomy with or without associated morbidities (7-11%) without exceeding the population percentage (12%). In our centre, the impact on hospital stay is more evident in complex procedures. The total savings in our centre during the years 2005-2006 compared with the XHUP hospitals group were 2212 days of hospital stay with an equivalent cost saving of more than one million euro. The frequency and the results of hospital stay and mortality of laparoscopic and open cholecystectomy were those expected for the population covered by a general hospital. The mortality in complex procedures was half of that of the whole public network or the ICS centres. CONCLUSIONS: In the complex hepatobiliary-pancreatic pathology, the mortality, and cost savings in our centre appear to be the result of, not only the high volume of procedures, but also to specialisation and factors related to the structure of the department, and surgeon training.

Resultados de la cirugía hepatobiliopancreática en un servicio de cirugía de un hospital de segundo nivel según los GRD durante el bienio 2005-2006 / Results of hepatobiliary and pancreatic surgery according to DRG in a level 2 hospital surgery department during the years 2005-2006

Objetivo. Evaluar los resultados de la cirugía hepatobiliopancreática de un servicio de cirugía durante el bienio 2005-2006, mediante los grupos relacionados por el diagnóstico. Materiales y método. Los datos se han obtenido del Registro del Conjunto Mínimo Básico de Datos de los Hospitales de Agudos del CatSalut. Se ha valorado la frecuencia, la estancia y la mortalidad. Los resultados han sido comparados con los 63 hospitales públicos de Cataluña (XHUP) y con los 8 de ellos que pertenecen al Instituto Catalán de la Salud (ICS). Resultados. Se observa, en nuestra área de influencia, una clara tendencia a la referencia para cierto tipo de procedimientos complejos (7-11%), sin superarla proporción poblacional (12%). En nuestro centro, el impacto en las estancias hospitalarias es más evidente en los procedimientos complejos. El ahorro total de recursos de nuestro servicio en el bienio2005-2006 en relación con el grupo de hospitales de la XHUP fue de 2.212 días de estancia hospitalaria, cuyo coste equivale a más de un millón de euros. La frecuencia y los resultados sobre las estancias hospitalarias y la mortalidad de la colecistectomía son los esperados para la población que se atiende como hospital general. La mortalidad en los procedimientos complejos fue la mitad que la observada para el conjunto de hospitales de la XHUP o del ICS. Conclusiones. En la patología hepatobiliopancreática compleja, creemos que la mortalidad y el ahorro de recursos en nuestro centro se deben no sólo al volumen, sino a la especialización y los factores relacionados con la estructura del servicio y el entrenamiento de los cirujanos (AU)

Objective. To assess the results of the hepatobiliary and pancreatic surgery of a surgery department during2005-2006 using the diagnostic related groups. Materials and method. The data were obtained from the CMBD-HA of the Catalan Health Service. We assessed the frequency, hospital stay and mortality of the surgical procedures. The results were compared with the 63 public hospitals, and the 8 of them belonging to the Catalan Health Institute. Results. In our area, a clear trend is observed in referrals for certain types of complex procedures on the liver, pancreas and biliary system excluding cholecystectomy with or without associated morbidities(7-11%) without exceeding the population percentage(12%). In our centre, the impact on hospital stay is more evident in complex procedures. The total savings in our centre during the years 2005-2006 compared with the XHUP hospitals group were 2212 days of hospital stay with an equivalent cost saving of more than one million euro. The frequency and the results of hospital stay and mortality of laparoscopic and open cholecystectomy were those expected for the population covered by a general hospital. The mortality in complex procedures was half of that of the whole public network or the ICS centres. Conclusions. In the complex hepatobiliary-pancreatic pathology, the mortality, and cost savings in our centre appear to be the result of, not only the high volume of procedures, but also to specialization and factors related to the structure of the department, and surgeon training (AU)