Análisis de costes y ahorros potenciales relacionados con la utilización de pruebas preoperatorias en los hospitales de Canarias
Cost analysis and potential savings related to the use of preoperative tests in the hospitals of the Canary Islands [Spain]
J. López-Bastida
, P. Serrano-Aguilar, B. Duque-González, A. Talavera-Déniz
Autor para correspondencia
jlopbas@gobiernodecanarias.org
Correspondencia: J. López-Bastida. Pérez de Rozas, 5, 4.°. 38004 Santa Cruz de Tenerife. España.
Correspondencia: J. López-Bastida. Pérez de Rozas, 5, 4.°. 38004 Santa Cruz de Tenerife. España.
Dirección del Servicio Canario de Salud. Servicio Canario de Salud. Santa Cruz de Tenerife. España
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"apellidos" => "Serrano-Aguilar" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Duque-González" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Talavera-Déniz" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Dirección del Servicio Canario de Salud. Servicio Canario de Salud. Santa Cruz de Tenerife. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleItalic">Correspondencia</span>: J. López-Bastida. Pérez de Rozas, 5, 4.°. 38004 Santa Cruz de Tenerife. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cost analysis and potential savings related to the use of preoperative tests in the hospitals of the Canary Islands [Spain]" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-01-31" "fechaAceptado" => "2002-11-29" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec268775" "palabras" => array:5 [ 0 => "Pruebas preoperatorias" 1 => "Anestesiología" 2 => "Costes" 3 => "Hospital" 4 => "Canarias" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec268776" "palabras" => array:5 [ 0 => "Preoperative tests" 1 => "Anesthesiology" 2 => "Costs" 3 => "Hospital" 4 => "Canary Islands" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estimar el ahorro potencial que podría tener lugar en el Servicio Canario de Salud (SCS), a partir de una utilización apropiada científica de las pruebas preoperatorias, haciendo uso de la información obtenida de los 5 hospitales universitarios de la red pública.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Un total de 55 anestesiólogos (60%) del SCS cumplimentaron un cuestionario. En éste se prestó especial atención a las pruebas preoperatorias más frecuentemente utilizadas, como la radiografía de tórax, el electrocardiograma, las pruebas de laboratorio y la espirometría. Los costes unitarios medios para las diferentes pruebas preoperatorias se obtuvieron de 2 hospitales participantes en el estudio. Para calcular los ahorros potenciales derivados del uso apropiado de las pruebas preoperatorias se han considerado varios escenarios caracterizados por diferentes hipótesis o grados de cumplimiento de un protocolo basado en el conocimiento científico, considerado como parámetro de referencia.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En el caso ideal de que se cumpliera el protocolo científico recomendado en el 100% de los 16.179 pacientes considerados ASA I y II, la repercusión económica sería notable, pues supondría una liberación de recursos sensible que podría ser utilizada para otros programas de salud. Estas cifras podrían alcanzar aproximadamente los 1,02 millones de euros, sin considerar el coste de la estancia preoperatoria. Esta cifra podría incrementarse hasta, aproximadamente, los 2,13 millones de euros si incluimos un día de estancia preoperatoria, y hasta los 3,24 millones de euros incluyendo 2 días de estancia preoperatoria.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La revisión reciente de la literatura científica y los resultados proporcionados por el cuestionario aplicado en el SCS indican que las pruebas preoperatorias alcanzan los mayores beneficios para los pacientes y para la sociedad si se guían por el conocimiento científico. Es posible, además, liberar recursos a partir de una mejor selección y utilización de las pruebas preoperatorias.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To estimate the potential cost savings that might take place in the Canary Islands Health Service (CHS) through the appropriate scientific use of preoperative tests, using information obtained from five public university hospitals.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A questionnaire was completed by 55 anesthesiologists, representing 60% of the total in the CHS. The questionnaire paid special attention to the most frequently used preoperative tests: chest radiograph, electrocardiogram, laboratory tests, and spirometry. The mean unit costs for the various preoperative tests were obtained from the two hospitals participating in the study. To calculate the potential cost savings derived from the appropriate use of preoperative tests, several scenarios were considered. These were characterized by different hypotheses or degrees of fulfillment of a protocol based on scientific knowledge and considered as the gold standard.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In the ideal scenario in which the recommended scientific protocol was fulfilled in 100% of the 16 179 patients with an American Society of Anesthesiologists (ASA) grade of I-II, the economic impact would be notable, since it would free sensitive resources that could be used for other health programs. These figures could amount to approximately 1.02 million euros, without considering the cost of preoperative hospital stay. This figure could increase by up to approximately 2.13 million euros if one day of preoperative hospital stay were included and by up to 3.24 million euros if two days of preoperative hospital stay were included.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The recent literature review and the results of the questionnaire applied in the CHS indicate that preoperative tests are of greatest benefit to patients and to society if their use is guided by scientific knowledge. In addition, resources can be freed by better selection and utilization of preoperative tests.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Biblografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 5 | 5 | 10 |
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| 2021 Diciembre | 21 | 43 | 64 |
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| 2020 Octubre | 30 | 14 | 44 |
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| 2020 Agosto | 15 | 19 | 34 |
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| 2020 Marzo | 19 | 5 | 24 |
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| 2019 Diciembre | 10 | 10 | 20 |
| 2019 Noviembre | 11 | 7 | 18 |
| 2019 Octubre | 18 | 3 | 21 |
| 2019 Septiembre | 5 | 8 | 13 |
| 2019 Agosto | 7 | 7 | 14 |
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| 2019 Enero | 4 | 9 | 13 |
| 2018 Diciembre | 2 | 6 | 8 |
| 2018 Noviembre | 15 | 7 | 22 |
| 2018 Octubre | 31 | 20 | 51 |
| 2018 Septiembre | 20 | 10 | 30 |
| 2018 Agosto | 11 | 10 | 21 |
| 2018 Julio | 25 | 5 | 30 |
| 2018 Junio | 23 | 14 | 37 |
| 2018 Mayo | 18 | 11 | 29 |
| 2018 Abril | 32 | 5 | 37 |
| 2018 Marzo | 11 | 7 | 18 |
| 2018 Febrero | 16 | 6 | 22 |
| 2018 Enero | 4 | 4 | 8 |
| 2017 Diciembre | 19 | 5 | 24 |
| 2017 Noviembre | 9 | 13 | 22 |
| 2017 Octubre | 13 | 8 | 21 |
| 2017 Septiembre | 8 | 8 | 16 |
| 2017 Agosto | 12 | 13 | 25 |
| 2017 Julio | 17 | 9 | 26 |
| 2017 Junio | 19 | 9 | 28 |
| 2017 Mayo | 16 | 11 | 27 |
| 2017 Abril | 20 | 12 | 32 |
| 2017 Marzo | 14 | 4 | 18 |
| 2017 Febrero | 7 | 3 | 10 |
| 2017 Enero | 5 | 3 | 8 |
| 2016 Diciembre | 25 | 8 | 33 |
| 2016 Noviembre | 13 | 5 | 18 |
| 2016 Octubre | 22 | 16 | 38 |
| 2016 Septiembre | 15 | 10 | 25 |
| 2016 Agosto | 32 | 6 | 38 |
| 2016 Julio | 21 | 13 | 34 |
| 2016 Mayo | 1 | 0 | 1 |
| 2016 Febrero | 1 | 0 | 1 |
| 2015 Diciembre | 1 | 0 | 1 |
| 2015 Septiembre | 1 | 0 | 1 |
| 2015 Junio | 2 | 0 | 2 |
| 2015 Abril | 1 | 0 | 1 |
| 2015 Marzo | 1 | 0 | 1 |
| 2015 Enero | 1 | 0 | 1 |
| 2014 Diciembre | 6 | 0 | 6 |
| 2014 Noviembre | 2 | 0 | 2 |
| 2014 Octubre | 3 | 0 | 3 |
| 2014 Septiembre | 3 | 1 | 4 |
| 2014 Agosto | 11 | 4 | 15 |
| 2014 Julio | 7 | 2 | 9 |
| 2014 Junio | 5 | 3 | 8 |
| 2014 Mayo | 2 | 1 | 3 |
| 2014 Abril | 5 | 2 | 7 |
| 2014 Marzo | 9 | 2 | 11 |
| 2014 Febrero | 11 | 0 | 11 |
| 2014 Enero | 7 | 2 | 9 |
| 2013 Diciembre | 7 | 2 | 9 |
| 2013 Noviembre | 19 | 3 | 22 |
| 2013 Octubre | 20 | 4 | 24 |
| 2013 Septiembre | 16 | 2 | 18 |
| 2013 Agosto | 28 | 4 | 32 |
| 2013 Julio | 20 | 1 | 21 |
| 2003 Marzo | 813 | 0 | 813 |
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