[Analysis of pediatric «short stays¼ in a second-level hospital throughout 25 years]. / Análisis de las «estancias cero¼ pediátricas en un hospital de nivel 2 a lo largo de 25 años.

INTRODUCTION: It is essential to admit patients to hospital in an efficient way in order to use resources rationally. Short hospitalary stays are hospitalizations which does not include 00:00h and are considered avoidable. This study describes trends and characteristics of short stays throughout 25 years in our hospital. PATIENTS AND METHODS: We analyzed hospital pediatric discharges in a second-level hospital through the registration system «conjunto mínimo básico de datos¼. We categorized pediatric patients and newborn patients in two groups according to length of hospital stay: «short stays¼ and «prolonged stays¼. We analyzed and compared the following variables: gender, age, type of admission, month, diagnosis-related groups (DRG) and admission service. Binary logistic regression analysis and assessment of trends through joinpoint regression analysis were performed. RESULTS: From 1993 to 2017, 45710 children were admitted to our hospital, of which 7.3% were short stays. The trend analysis showed a point of change upwards-downwards at the beginning of the millennium. Pediatric short stays: the most important variables were emergency admissions (89%), urgent transfers (9%), month December (11%) and main diagnosis category: nervous system (18%). Mean diagnosis-related groups cost was 2432±1115€ in short stays group and 2549±1065€ in prolonged stays. CONCLUSIONS: Short stays and prolonged stays show a falling trend in our hospital. Short stays percentage in our environment is similar to other neighbor countries. Some of our short stays are urgent transfers and admissions for clinical observation. We did not find clinical significance in weight or cost of pediatric patients' DRG comparing to prolonged stays.

Tendencias en la hospitalización psiquiátrica por alcoholy drogas en Castilla y León entre 2005 y 2015 / Trends in psychiatric hospitalization for alcohol and drugs in Castilla y León between 2005 and 2015

A nivel mundial, se ha estimado que el alcohol, el tabaco y las drogashan sido responsables de más de 10 millones de muertes en 2016, yque existe mucho margen para reducir la mortalidad. Se han realizadoavances en la extracción de información de bases de datos administrativas con el fin de analizar grandes volúmenes de datos sanitarios. Hemosestudiado las tendencias en las tasas de hospitalización con diagnóstico de adicción a alcohol y drogas durante once años con el softwareJoinpoint Trend Analysis. Se trata de un estudio descriptivo de asociación cruzada de 3.758 ingresos hospitalarios de pacientes con diagnóstico principal de abuso o dependencia de alcohol y drogas en unidadesde Psiquiatría de centros públicos de Castilla y León entre 2005 y 2015.Las tendencias en la hospitalización por adicción al alcohol y/o drogasdisminuyeron a lo largo de los once años. Además de una reducciónestadísticamente significativa de los ingresos por alcohol y cocaína, seapreció una fuerte tendencia al alza en los ingresos por cannabis entre2013 y 2015. El alcohol fue durante todo el periodo de estudio la principal causa de ingreso y el que más días de hospitalización ha generado.No obstante, en los 11 años se observó una reducción progresiva y constante en los ingresos por todas las sustancias a excepción del cannabis.La metodología utilizada ya ha demostrado ser muy útil para identificarcambios de tendencias en diferentes patologías. (AU)

It has been estimated that alcohol, tobacco, and illicit drugs were responsible for more than 10 million deaths worldwide in 2016, andthere are many opportunities for improvement. Regarding innovativedata analysis, advances have been made in the extraction of information from administrative databases for analytics purposes. We studiedtrends in hospitalization rates for alcohol and drug abuse over elevenyears with Joinpoint Trend Analysis software. This is a descriptive studyof cross-associations in 3,758 hospital admissions of patients admittedwith a main diagnosis of alcohol and drug abuse or dependence inpsychiatry units of public health centres of Castilla y León (Spain)between 2005 and 2015. Hospitalization trends for alcohol and drugrelated conditions declined over the eleven-year period. Separately,there was a statistically significant decrease in alcohol and cocainerelated conditions, but a strong upward trend in cannabis relatedconditions between 2013 and 2015. Alcohol was the main cause ofadmission to psychiatric units with a diagnosis of addiction. In the11 years researched, there was a progressive and constant reductionin admissions for substance use except for cannabis. The innovativestatistical methodology has already proven to be useful for identifyingtrends and changes in different pathologies over time. (AU)