急性阑尾炎：呈下降趋势？

Acute appendicitis: a descending trend?

作者信息

Cirocchi R, Morelli U, La Mura F, Cattorini L, Napolitano V, Galanov I, Covarelli P, Giustozzi G, Sciannameo F

机构信息

General Surgery and Emergency Clinic, Hospital S. Maria, Terni, University of Perugia, Italy.

出版信息

Minerva Chir. 2008 Apr;63(2):109-13.

PMID:18427443

Abstract

AIM

The diagnosis-related group (DRG) system is a prospective hospital payment system used to categorize hospital patients expected to require similar hospital services. In Italy, hospital productivity is calculated from DRG-based data coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), which is a classification system for coding of diagnoses and operations for indexing medical records by diagnosis and operations. The aim of our survey was to determine the national incidence of appendectomies based on the coded summary of selected data in hospital discharge reports (HDR).

METHODS

The Italian Ministry of Health online database was searched for data collected between 2001 and 2003. The search engine allows analysis by different regions but not by individual hospital. The national incidence of appendectomy was calculated using data collected from the ICD-9-CM and from the HDR. In a deeper analysis, regional data and data from individual hospitals were compared.

RESULTS

The analysis revealed the incidence of appendectomy, rates of simple acute appendicitis vs complicated appendicitis, common laparotomic appendectomy vs laparoscopic appendectomy, as well as mean duration of hospitalization.

CONCLUSION

The incidence of acute appendicitis has considerably decreased, whereas the rates of complicated appendicitis have increased because of longer diagnostic and therapeutic delay, inappropriate antibiotic therapy and upclassifying of diagnosis and procedures in the HDR (ICD-9-CM) in order to obtain a ''wider impact'' on DRG.

摘要

目的

诊断相关分组（DRG）系统是一种前瞻性医院付费系统，用于对预计需要类似医院服务的患者进行分类。在意大利，医院生产率是根据按照《国际疾病分类，第九次修订本，临床修订版》（ICD - 9 - CM）编码的基于DRG的数据来计算的，ICD - 9 - CM是一种用于对诊断和手术进行编码的分类系统，以便通过诊断和手术对医疗记录进行索引。我们此次调查的目的是根据医院出院报告（HDR）中选定数据的编码汇总来确定全国阑尾切除术的发生率。