Soncini M, Leo P, Triossi O, Buniolo C
Department of Gastroenterology, S. Carlo Borromeo Hospital, via Pio II 3, Milan, Italy.
Minerva Gastroenterol Dietol. 2008 Jun;54(2):115-22.
Computer systems in hospitals provide information on the work of each single operative unit and the complexity of its caselist. However, in Italy, there is no official data-base for Gastroenterology Departments, to summarize their work.
The RING (Ricerca-INformatizzata-in-Gastroenterologia) study has collected, through a software made on purpose, 113 237 hospital discharge files (HDF) from 55 Italian hospital Gastroenterology Units, since 2001. This caselist provides a picture of the patients and is useful for clinical/management evaluation.
Between January 2001 and December 2006, 55 Gastroenterology Units gathered 88240 HDF referring to ''ordinary admissions''. The male:female rate was 1:1, mean age was 61.3+/-18.5 years. Mean hospital stay was around eight days. Over the years there was a significant drop in DRG183 (miscellaneous digestive disorders-without complications) from 11.5% to 7.4% (P<0.0001), with no similar increase in DRG182 (with complications) which rose from 3.1% to 4.0%. Principal discharge diagnoses are post-hepatic and alcohol-related cirrhosis, hepatocarcinoma, acute pancreatitis, duodenal/gastric ulcer.
The RING data show that the gastroenterologist has been working increasingly with patients whose pathologies would have been ''inappropriately'' treated surgically (DRGs 204 and 174). Inappropriate gastroenterological treatment seems to have decreased as well as the DRG183 with no apparent ''opportunistic'' compensatory increase in DRGs with complications, such as 182.
医院的计算机系统提供每个单一手术单元的工作信息及其病例列表的复杂性。然而,在意大利,没有官方数据库来汇总胃肠病科的工作。
自2001年以来,RING(胃肠病学信息研究)研究通过专门制作的软件,从意大利55家医院的胃肠病科收集了113237份医院出院文件(HDF)。该病例列表展示了患者情况,对临床/管理评估很有用。
2001年1月至2006年12月期间,55个胃肠病科收集了88240份涉及“普通住院”的HDF。男女比例为1:1,平均年龄为61.3±18.5岁。平均住院时间约为8天。多年来,DRG183(无并发症的其他消化系统疾病)从11.5%显著下降至7.4%(P<0.0001),而DRG182(有并发症)从3.1%上升至4.0%,没有类似的增加。主要出院诊断为肝后性和酒精性肝硬化、肝癌、急性胰腺炎、十二指肠/胃溃疡。
RING数据表明,胃肠病医生越来越多地治疗那些其病情“不适合”手术治疗的患者(DRGs 204和174)。不适当的胃肠病治疗似乎有所减少,DRG183也是如此,而有并发症的DRGs(如182)没有明显的“机会性”代偿性增加。