[Prevalence of processes and pathologies in emergency hospital care]. / Prevalencia de procesos y patologías en la atención urgente hospitalaria.

OBJECTIVES: To study the behavioural differences between scheduled and emergency admissions in the processes most prevalent in Spanish hospitals and their relationship with the age of patients, comparing 2002 and 2007. METHODS: Observational and descriptive design for those years. Diagnostic related groups (DRGs) were classified into high prevalence (the 25 most frequent) and the rest; four subgroups were prepared according to this (high or low) and admission (elective or not). Mean length of stay was analyzed, together with relative weight, number of diagnoses and procedures and mortality by age, using the Student and/or ANOVA tests for quantitative variables and Pearson's chi(2) qualitative comparison of means and proportions for tabular data, assuming statistical significance at p <0.05. RESULTS: The high prevalence and emergency admission subgroup has higher age, ratio of males, mean length of stay, mortality, number of diagnoses and procedures (all p <0.0001), in both 2002 and 2007. The complexity and resource consumption measured by such variables peaks in the 65-69 and 70-74 cohorts respectively, with emergency admission. CONCLUSIONS: There are clear differences between the processes according to their prevalence and accessibility; priority must be given to knowledge and information on the most frequent and urgent admissions to improve the effectiveness, efficiency and quality.

Prevalencia de procesos y patologías en la atención urgente hospitalaria / Prevalence of processes and pathologies in emergency hospital care

Objetivos. Estudiar las diferencias de comportamientoentre ingresos urgentes y programados en los procesosmás prevalentes y el resto en la casuística hospitalariaespañola y su relación con la edad de los pacientes,comparando los años 2002 y 2007.Métodos. Diseño observacional y descriptivo duranteesos años. Se clasifican los grupos relacionados de diagnóstico(GRD) en alta prevalencia (25 más frecuentes)y resto, se confeccionan cuatro subgrupos según ésta(alta o baja) e ingreso (electivo o no). Se analiza estanciamedia, peso relativo, número de diagnósticos y procedimientosy mortalidad en función de la edad, por mediodel test de Student y/o ANOVA, según proceda, para variablescuantitativas y el de χ2 de Pearson para cualitativas,comparando ambas según análisis de datos ya tabulados.Se asume significación estadística para p<0,05.Resultados. El subgrupo de alta prevalencia e ingresourgente presenta mayor edad, proporción de varones,estancia media, mortalidad, número de diagnósticosy procedimientos (todo con p<0,0001), tanto en 2002como en 2007. La gravedad, complejidad y consumode recursos –medidos con esas variables– alcanza sumáximo en las cohortes de 65-69 y 70-74 años, respectivamente,con ingreso urgente.Conclusiones. Existen claras diferencias entre los procesos,según su prevalencia y acceso, y debe priorizarseel conocimiento y la información de los más frecuentesy urgentes para mejorar la efectividad, la eficienciay la calidad(AU)

Objectives. To study the behavioural differences betweenscheduled and emergency admissions in the processesmost prevalent in Spanish hospitals and theirrelationship with the age of patients, comparing 2002and 2007.Methods. Observational and descriptive design forthose years. Diagnostic related groups (DRGs) wereclassified into high prevalence (the 25 most frequent)and the rest; four subgroups were prepared accordingto this (high or low) and admission (elective or not).Mean length of stay was analyzed, together with relativeweight, number of diagnoses and procedures andmortality by age, using the Student and/or ANOVA testsfor quantitative variables and Pearson’s χ2 qualitativecomparison of means and proportions for tabular data,assuming statistical significance at p <0.05.Results. The high prevalence and emergency admissionsubgroup has higher age, ratio of males, mean lengthof stay, mortality, number of diagnoses and procedures(all p <0.0001), in both 2002 and 2007. The complexityand resource consumption measured by such variablespeaks in the 65-69 and 70-74 cohorts respectively, withemergency admission.Conclusions. There are clear differences between theprocesses according to their prevalence and accessibility;priority must be given to knowledge and informationon the most frequent and urgent admissions toimprove the effectiveness, efficiency and quality(AU)