Suárez García F, Oterino de la Fuente D, Peiró S, Librero J, Barrero Raya C, Parras García de León N, Crespo Pérez M A, Peréz-Martín A
Dirección General de Ordenación de Servicios Sanitarios, Consejería de Salud y Servicios Sanitarios del Principado de Asturias.
Rev Esp Salud Publica. 2001 May-Jun;75(3):237-48.
Some social, medical or functional aspects are associated with a greater use of health care resources, although this does not necessarily imply an inappropriate usage of the same. The aim of this research is that of ascertaining the influence of health condition on hospital stays and inappropriate stays among the population over 64 years of age.
A cohort representative of the population over age 64 in the Judicial District of Toledo (n = 3214) whose health condition had been previously evaluated was studied over an eighteen-month period identifying the income and length of stays at the public hospitals, the appropriateness of which was evaluated by the Appropriateness Evaluation Protocol. Associations analyzed were those of the cohort socio-demographic characteristics, health condition-related variables and morbidity with frequency and hospitalization rates and with inappropriate stays and admissions.
During the 18 months of study 410 individuals were hospitalized, who generated 546 admissions (frequency rate = 17.0 admissions/100 rooms) and 7015 stay days (hospitalization rate = 218.3 stays/100 rooms), 18.9% of the admissions and 49.9% of the stays were evaluated as inappropriate. Hospitalization was associated with a worse health condition, institutionalization, male sex, certain pathologies and previous health services usage. Patients characteristics were not associated with the percentage of inappropriate stays. 97.5% of inappropriate stays were attributed to hospital scheduling problems and physicians' practices.
Socio-demographic factors, morbidity, health condition and previous health service usage are shown as good hospitalization predictors for senior citizens, but these factors are not related to inappropriate hospitalization usage.
一些社会、医疗或功能方面与更多地使用医疗保健资源相关，尽管这不一定意味着对这些资源的使用不当。本研究的目的是确定健康状况对64岁以上人群住院时间和不当住院时间的影响。
对托莱多司法区64岁以上人群的一个具有代表性的队列（n = 3214）进行了为期18个月的研究，该队列的健康状况此前已得到评估，确定了其在公立医院的收入和住院时间，并通过适当性评估方案对住院的适当性进行了评估。分析的关联包括队列的社会人口统计学特征、与健康状况相关的变量和发病率与住院频率和住院率以及与不当住院和入院之间的关联。
在18个月的研究期间，410人住院，产生了546次入院（频率为17.0次入院/100人）和7015个住院日（住院率为218.3次住院/100人），18.9%的入院和49.9%的住院被评估为不当。住院与较差的健康状况、机构化、男性、某些疾病和以前使用医疗服务有关。患者特征与不当住院的比例无关。97.5%的不当住院归因于医院的排班问题和医生的做法。
社会人口统计学因素、发病率、健康状况和以前使用医疗服务的情况被证明是老年人住院的良好预测因素，但这些因素与不当住院使用无关。
