Journal Information
Vol. 8. Issue 43.
Pages 180-188 (July - August 1994)
Vol. 8. Issue 43.
Pages 180-188 (July - August 1994)
Open Access
Variaciones del tiempo de estancia postoperatoria según las características de los pacientes en un servicio de cirugía general
Variation in Length of Postoperative Stay Related to Patient Characteristics in a General Surgery Unit
Visits
4512
R.E. Jiménez Paneque*, Á.R. Gutiérrez Rojas, H. Fariñas Seijas, N. Suárez García, E. Fuentes Valdés
Hospital Clínico Quirúrgico “Hermanos Ameijeiras”, Ciudad de la Habana. Cuba
This item has received

Under a Creative Commons license
Article information
Resumen

Con el objetivo de identificar factores determinantes en la variación de la estancia postoperatoria en un servicio de Cirugía general, se recogió información de 666 historias clínicas de pacientes dados de alta vivos. Se evaluaron factores relacionados con la intervención, con la gravedad del diagnóstico principal, con el equipo médico de asistencia y características sociodemográficas del paciente. El análisis estadístico comprendió análisis de la varianza y regresión lineal múltiple. Las variables con coeficiente de regresión estadísticamente significativo (p<0,001) fueron, en orden de importancia: la gravedad de las complicaciones, el tipo de intervención, la necesidad de reintervención y la seriedad del diagnóstico principal. El 67% de la variación de la estancia fue explicada por las variables incluidas. Los resultados permiten sugerir un procedimiento evaluativo que contemple características de los pacientes y de la intervención quirúrgica.

Palabras clave:
Estancia médica
Revisión de la utilización
Summary

With the purpose of identifying factors that explain variations in length of postoperative stay in a general Surgery Unit, information from 666 clinical records of discharged alive patients was collected. Factors related to the surgical procedure, the severity of the disease and the medical team together with sociodemographic characteristics of the patients were analyzed. Statistical analysis was based on analysis of variance and multiple linear regression. Variables with statistically significant regression coefficients (p<0.001) were in this order: severity of complications, type of intervention, need for reintervention and severity of diagnosis. Sixty seven percent of length of stay variation was explained by the included variables. Results allow to suggest an evaluation procedure which takes into account patient and operation characteristics.

Key words:
Length of Stay
Utilization Review
Full text is only aviable in PDF
Biblografía
[1.]
S.E. Berki, M.L.F. Ashcraft, W.C. Newbrander.
Length of stay variations within ICD-8 Diagnosis-Related Groups.
Med Care, 22 (1984), pp. 126-142
[2.]
R.S. Rhodes, C.L. Krasniak, P.K. Jones.
Factors affecting length of hospital stay for femoropopliteal bypass. Implications of the DRGs.
N Engl J Med, 314 (1986), pp. 153-157
[3.]
M.D. Vollertsen, F.T. Nobrega, C.J. Michet, T.J. Hanson, J.M. Naessens.
Economic Outcome Under Medicare Prospective Payment at a Tertiary-Care Institution: The effects of Demographic, Clinical, and Logistic Factors on Duration of Hospital Stay and Past A Charges for Medical Back Problems (DRG 243).
Mayo Clin Proc, 63 (1988), pp. 583-591
[4.]
G. Fulop, J.J. Strain, J. Vita, J.S. Lyons, J.S. Hammer.
Impactof psychiatric comorbidity on length of hospital stay for medical/surgical patients: a preliminary report.
Am J Psychiatric, 144 (1987), pp. 878-888
[5.]
A.M. Epstein, R.S. Stern, J. Tognetti, et al.
The association of patient's socioeconomic characteristics with the length of hospital stay and hospital charges within diagnosis-related groups.
N Engl J Med, 318 (1988), pp. 1579-1584
[6.]
J.A. Chazan, M.R. London, L. Pono.
The impact of diagnosis related groups on the cost of hospitalization for end-stage renal disease patients at Rhode Island Hospital from 1987 to 1990.
Am J Kidney Dis, 19 (1992), pp. 523-525
[7.]
L. Marchette, F. Holloman.
Length of stay. Significant variables.
JONA, 16 (1986), pp. 12-19
[8.]
K.R. Jones.
Predicting hospital charge and stay variation.
Med Care, 23 (1985), pp. 220-235
[9.]
R.L. Wolverson, A.R.E. Blacklock, J.R. Geddes, A. O'Hagan.
Factors influencing Post-operative Hospital Stay after Transurethral Rersection of the Prostate Gland.
Brit J Urol, 58 (1986), pp. 161-163
[10.]
A. Planas, F.J. Gilsanz, S. García, R. Martínez, J. Vaquero.
Análisis de los factores que prolongan la estancia en la unidad de recuperación en el postoperatorio de cirugía neurovascular.
Rev Española Anest Rean, 34 (1987), pp. 362-364
[11.]
P.D. Cleary, S. Greenfield, A.G. Mulley, et al.
Variations in length of stay and outcomes for six medical and surgical conditions in Massachussetts and California.
JAMA, 266 (1991), pp. 73-79
[12.]
K. Verkkala.
Occurence of and microbiological findings in postoperative infections following open heart surgery. Effect on mortality and hospital stay.
Ann Clin Res, 19 (1987), pp. 170-177
[13.]
M. Morgan, E. Paul, H.B. Devlin.
Length of stay for common surgical procedures: Variation among districts.
Br J Surg, 74 (1987), pp. 884-889
[14.]
S.D. Horn, P.D. Sharkey, D.A. Bertram.
Measuring Severity of Illness: Homogeneous Case Mix Groups.
Med Care, 21 (1983), pp. 14-30
[15.]
S.D. Horn, R.A. Horn.
Reliability and Validity of the Severity of Illness Index.
Med Care, 24 (1986), pp. 159-178
[16.]
L.R. Bums, D.R. Wholey.
The Effects of Patients, Hospital, and Physician Characteristics on Length of Stay and Mortality.
Med Care, 29 (1991), pp. 251-271
[17.]
J. Askanazi, P.M. Starker, C. Olsson, et al.
Effect of Immediate Postoperative Nutricional Support on Length of Hospitalization.
Ann Surg, 203 (1986), pp. 236-239
[18.]
A.M. Epstein, J.L. Read, M. Hoefer.
The Relation of Body Weight to Length of Stay and Charges for Hospital Services for Patients Undergoing Elective Surgery: A Study of Two Procedures.
Am J Public Health, 77 (1987), pp. 993-997
[19.]
R. Jiménez, C. Hernández, N. Suárez.
Factores que influyen sobre el tiempo de estadía en un Servicio de Medicina Interna. Proposición de un nuevo indicador.
Informe final de investigaciones presentado en la Jornada de Investigaciones Terminadas,
[20.]
L.C. Silva, J. Machín.
Indicadores para evaluar el tiempo de estadía hospitalaria ajustadas según el estado de los pacientes al ingreso.
Rev Cub Salud Pública, 15 (1989), pp. 65-78
[21.]
S.D. Horn, P.D. Sharkey, J.M. Buckle, et al.
The Relationship Between Severity of Illness and Hospital Length of Stay and Mortality.
Med Care, 29 (1991), pp. 305-317
[22.]
D. Moher, A. Weinberg, R. Hanlon, K. Runnalls.
Effects of a medical team coordinator on length of hospital stay.
Can Med Assoc J, 146 (1992), pp. 511-515
Copyright © 1994. Sociedad Española de Salud Pública y Administración Sanitaria
Download PDF
Idiomas
Gaceta Sanitaria
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?