Zapatero Gaviria Antonio, Barba Martín Raquel, Canora Lebrato Jesús, Losa García Juan Emilio, Plaza Canteli Susana, Marco Martínez Javier
Medicina Interna, Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, España.
Med Clin (Barc). 2010 Jan 23;134(1):6-12. doi: 10.1016/j.medcli.2009.04.050. Epub 2009 Jul 30.
Mortality is an important indicator of clinical activity. The aim of this paper is to analyze the mortality in Internal Medicine (IM) departments in our country taking into account the characteristics of the patients seen at our hospitals.
Patients attended at the IM Departments of Spanish hospitals during 2006 were analyzed through the CMBD (minimum basic set of data; in Spanish: <<Conjunto Mínimo Básico de Datos>>) which collects administrative and clinical data of all patients admitted to the public and private hospital of our state. Global and specific mortality by DRG were established and compared with the national standard published by the Spanish Health and Consume Ministry for that same year.
In general hospitals of the National Health Service for the year 2006, 3,589,718 patients were discharged, 522,268 (14.5%) of them from IM departments. Of this last group, 46.6% were female, with a mean age of 70.4 years (SD 11.6) and a mean weight of 1.72 (SD 1.39). Global mortality was 9.5% compared to a national standard of 4.1%. Comparing by DRG, mortality was in general higher in IM.
Global mortality as well as specific mortality by DRG is higher than the general mortality. This could be explained by the characteristics of the population admitted in IM: older, seriously ill, with more co-morbidities, admitted trough the emergency department and consuming more resources than the general population.
死亡率是临床活动的一项重要指标。本文旨在结合我国医院就诊患者的特征,分析我国内科(IM)科室的死亡率。
通过CMBD(最低基本数据集;西班牙语:<<Conjunto Mínimo Básico de Datos>>)对2006年西班牙医院内科收治的患者进行分析,该数据集收集了我国公立和私立医院所有住院患者的行政和临床数据。确定了按疾病诊断相关分组(DRG)的总体死亡率和特定死亡率,并与西班牙卫生与消费部同年公布的国家标准进行比较。
2006年国家卫生服务体系的综合医院共出院3589718例患者,其中522268例(14.5%)来自内科。在这最后一组患者中,46.6%为女性,平均年龄70.4岁(标准差11.6),平均体重1.72(标准差1.39)。总体死亡率为9.5%,而国家标准为4.1%。按DRG比较,内科的死亡率总体上更高。
总体死亡率以及按DRG的特定死亡率均高于一般死亡率。这可以通过内科收治人群的特征来解释:年龄较大、病情严重、合并症较多、通过急诊科入院且比一般人群消耗更多资源。