Llopis Roca Ferrán, Ferré Losa Carles, Juan Pastor Antoni, Martín Sánchez Francisco Javier, Sempere Montes Gonzalo, Jacob Rodríguez Javier, Llorens Soriano Pere, Navarro Bustos Carmen, Martínez Ortiz de Zárate Mikel
Servicio de Urgencias, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Unidad de Corta Estancia de Urgencias, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Emergencias. 2015;27(2):109-112.
To compare the efficiency of short-stay units (SSUs) managed by different departments within hospitals.
Cross-sectional study in 40 hospitals with SSUs. From June 1 to December 31, 2012,we gathered data on clinical caseloads and management. Variables directly related to efficiency were mean length of stay, bed rotation index, and weekend discharge rate.
Forty SSUs were studied; 25 (62.5%) were managed by the hospital's emergency department (ED), 9 (22.5%) were managed by the internal medicine department (IMD), 5 (12.5%) were independent, and 1 was jointly managed by the hospital's ED and the IMD. A total of 45 140 patients were discharged from the SSUs. The most common diagnoses were exacerbation of chronic heart or respiratory disease, urinary tract infection, and respiratory infection. Age was the only variable that was related to the hospital department designated to manage these SSUs. The mean ages by management type were as follows: independent SSUs (75.6 years) vs ED-managed SSUs (67.2 years) vs IMD-managed SSUs (57.8 years) (P=.02). Group-by-group comparisons showed that the mean length of stay was shorter in ED-managed SSUs than in IMD-managed units (2.65 vs 3.73 respectively; P=.047), and overall mortality was lower in IMD-managed SSUs than in ED-managed SSUs (0.64% vs 3%; P=.033). However, unforeseen mortality (after excluding patients under palliative care or judged to be in the final hours of life) did not differ significantly between groups.
We did not detect important differences between SSUs managed by different departments in the hospitals in this series. However, mean length of stay was found to be shorter in ED-managed SSUs than in IMD-managed units.
比较医院内不同科室管理的短期住院单元（SSU）的效率。
对40家设有SSU的医院进行横断面研究。2012年6月1日至12月31日，我们收集了临床病例数量及管理方面的数据。与效率直接相关的变量包括平均住院时间、床位周转指数和周末出院率。
共研究了40个SSU；其中25个（62.5%）由医院急诊科（ED）管理，9个（22.5%）由内科（IMD）管理，5个（12.5%）为独立单元，1个由医院ED和IMD共同管理。SSU共出院45140例患者。最常见的诊断为慢性心脏或呼吸系统疾病加重、尿路感染和呼吸道感染。年龄是唯一与指定管理这些SSU的医院科室相关的变量。按管理类型划分的平均年龄如下：独立SSU（75.6岁）、ED管理的SSU（67.2岁）、IMD管理的SSU（57.8岁）（P = 0.02）。逐组比较显示，ED管理的SSU的平均住院时间比IMD管理的单元短（分别为2.65天和3.73天；P = 0.047），IMD管理的SSU的总体死亡率低于ED管理的SSU（0.64%对3%；P = 0.033）。然而，意外死亡率（排除接受姑息治疗或被判定处于生命最后阶段的患者后）在各组之间无显著差异。
在本系列研究中，我们未发现医院内不同科室管理的SSU之间存在重要差异。然而，发现ED管理的SSU的平均住院时间比IMD管理的单元短。
