Hernández Miguel María Victoria, Martín Martínez María Auxiliadora, Corominas Héctor, Sanchez-Piedra Carlos, Sanmartí Raimon, Fernandez Martinez Carmen, García-Vicuña Rosario
Servicio de Reumatología, Hospital Clínic de Barcelona-IDIBAPS, Barcelona, España.
Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España.
Reumatol Clin. 2017 Jan-Feb;13(1):10-16. doi: 10.1016/j.reuma.2016.01.007. Epub 2016 Mar 9.
To describe the variability of the day care hospital units (DCHUs) of Rheumatology in Spain, in terms of structural resources and operating processes.
Multicenter descriptive study with data from a self-completed questionnaire of DCHUs self-assessment based on DCHUs quality standards of the Spanish Society of Rheumatology. Structural resources and operating processes were analyzed and stratified by hospital complexity (regional, general, major and complex). Variability was determined using the coefficient of variation (CV) of the variable with clinical relevance that presented statistically significant differences when was compared by centers.
A total of 89 hospitals (16 autonomous regions and Melilla) were included in the analysis. 11.2% of hospitals are regional, 22,5% general, 27%, major and 39,3% complex. A total of 92% of DCHUs were polyvalent. The number of treatments applied, the coordination between DCHUs and hospital pharmacy and the post graduate training process were the variables that showed statistically significant differences depending on the complexity of hospital. The highest rate of rheumatologic treatments was found in complex hospitals (2.97 per 1,000 population), and the lowest in general hospitals (2.01 per 1,000 population). The CV was 0.88 in major hospitals; 0.86 in regional; 0.76 in general, and 0.72 in the complex.
there was variability in the number of treatments delivered in DCHUs, being greater in major hospitals and then in regional centers. Nonetheless, the variability in terms of structure and function does not seem due to differences in center complexity.
从结构资源和运营流程方面描述西班牙日间护理医院的风湿病单元（DCHUs）的变异性。
采用多中心描述性研究，数据来自基于西班牙风湿病学会DCHUs质量标准的DCHUs自我评估自填问卷。分析结构资源和运营流程，并按医院复杂性（区域、综合、大型和复杂）进行分层。使用具有临床相关性的变量的变异系数（CV）来确定变异性，该变量在中心间比较时呈现出统计学上的显著差异。
分析共纳入89家医院（16个自治区和梅利利亚）。11.2%的医院为区域性医院，22.5%为综合性医院，27%为大型医院，39.3%为复杂医院。92%的DCHUs具有多种功能。所应用治疗的数量、DCHUs与医院药房之间的协调以及研究生培训过程是根据医院复杂性显示出统计学显著差异的变量。复杂医院的风湿病治疗率最高（每千人口2.97例），综合医院最低（每千人口2.01例）。大型医院的CV为0.88；区域医院为0.86；综合医院为0.76，复杂医院为0.72。
DCHUs提供的治疗数量存在变异性，大型医院的变异性更大，其次是区域中心。然而，结构和功能方面的变异性似乎并非由于中心复杂性的差异。
