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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las variaciones en la asistencia de las enfermedades nasosinusales entre comunidades aut&#243;nomas &#40;CCAA&#41; y hospitales espa&#241;oles&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analiz&#243; el Conjunto M&#237;nimo B&#225;sico de Datos del Sistema Nacional de Salud de los a&#241;os 1998-2000 para los diagn&#243;sticos de p&#243;lipos nasosinusales y sinusitis cr&#243;nica&#46; Se estudi&#243; la distribuci&#243;n por CCAA de la tasa de hospitalizaci&#243;n y de 4 indicadores de calidad asistencial y eficiencia&#58; estancia media&#44; porcentajes de altas sin intervenci&#243;n&#44; t&#233;cnicas de cirug&#237;a endosc&#243;pica nasosinusal y complicaciones posquir&#250;rgicas&#46; Se realiz&#243; un an&#225;lisis de conglomerados para clasificar los hospitales seg&#250;n los valores de dichos indicadores&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 13&#46;061 altas de 263 hospitales&#46; Se hallaron importantes diferencias en las tasas de hospitalizaci&#243;n ajustadas por edad de diferentes CCAA&#46; El an&#225;lisis de conglomerados agrup&#243; los centros con m&#225;s de 10 altas anuales en 3 categor&#237;as&#58; a&#41; 32 hospitales con los 4 indicadores de calidad en mejor situaci&#243;n que el promedio&#59; b&#41; 35 hospitales con 3 de los indicadores por debajo del promedio&#44; y c&#41; 74 hospitales con 2 indicadores mejores y 2 indicadores peores que el promedio&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Hay importantes variaciones interregionales en la frecuentaci&#243;n de ingresos&#44; as&#237; como en las caracter&#237;sticas de la atenci&#243;n de las enfermedades nasosinusales en los hospitales espa&#241;oles&#44; y se han observado 3 patrones definidos de centros en funci&#243;n de sus indicadores de calidad y eficiencia&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe variations in the management of nasosinus disorders among the Autonomous Communities and hospitals of Spain&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We analyzed the Minimum Basic Data Set of the public health system from 1998-2000 for the diagnoses of nasosinus polyps and chronic sinusitis&#46; We studied the distribution by regions of the rate of hospitalizations and of 4 indicators of quality of care and efficiency&#58; mean length of stay&#44; percentage of discharges without surgery&#44; percentage of functional endoscopic sinus surgery and surgical complications&#46; A cluster analysis was performed to classify hospitals according to the values of these indicators&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We analyzed 13061 discharges from 263 hospitals&#46; Marked differences were found in age-adjusted hospitalization rates by regions&#46; Cluster analysis classified the centers with more than 10 annual discharges in 3 categories&#58; a&#41; 32 hospitals in which the 4 quality indicators were above average&#59; b&#41; 35 hospitals in which 3 of the indicators were below average&#44; and c&#41; 74 hospitals in which 2 indicators were above average and 2 indicators were below average&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Marked interregional variations were found in hospitalization rates&#44; as well as in the characteristics of management of nasosinus disorders in Spanish hospitals&#46; The centers examined could be grouped into three clearly defined patterns according to indicators of quality of care and efficiency&#46;</p>"
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Variabilidad en la asistencia hospitalaria. El caso de la cirugía nasosinusal en España
Variability in hospital care. Nasosinus surgery in Spain
Alberto Jiménez-Puentea,*]
Autor para correspondencia
ajpuente@hcs.es

Correspondencia: Hospital Costa del Sol. 29600 Marbella. Málaga. España. Correo electrónico:
, David Piédrola-Marotob, Emilio Perea-Millaa, Antonio Lara-Blanquera, Joana Pons-Pallisera, Ana Bandera-Floridoc, Víctor Sarmiento González-Nietod
a Dirección de Sistemas de Información. Hospital Costa del Sol. Marbella. Málaga
b Unidad de Otorrinolaringología. Hospital Costa del Sol. Marbella. Málaga
c Distrito Sanitario Málaga
d Servicios Centrales. Servicio Andaluz de Salud. Sevilla. España
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las variaciones en la asistencia de las enfermedades nasosinusales entre comunidades aut&#243;nomas &#40;CCAA&#41; y hospitales espa&#241;oles&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analiz&#243; el Conjunto M&#237;nimo B&#225;sico de Datos del Sistema Nacional de Salud de los a&#241;os 1998-2000 para los diagn&#243;sticos de p&#243;lipos nasosinusales y sinusitis cr&#243;nica&#46; Se estudi&#243; la distribuci&#243;n por CCAA de la tasa de hospitalizaci&#243;n y de 4 indicadores de calidad asistencial y eficiencia&#58; estancia media&#44; porcentajes de altas sin intervenci&#243;n&#44; t&#233;cnicas de cirug&#237;a endosc&#243;pica nasosinusal y complicaciones posquir&#250;rgicas&#46; Se realiz&#243; un an&#225;lisis de conglomerados para clasificar los hospitales seg&#250;n los valores de dichos indicadores&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 13&#46;061 altas de 263 hospitales&#46; Se hallaron importantes diferencias en las tasas de hospitalizaci&#243;n ajustadas por edad de diferentes CCAA&#46; El an&#225;lisis de conglomerados agrup&#243; los centros con m&#225;s de 10 altas anuales en 3 categor&#237;as&#58; a&#41; 32 hospitales con los 4 indicadores de calidad en mejor situaci&#243;n que el promedio&#59; b&#41; 35 hospitales con 3 de los indicadores por debajo del promedio&#44; y c&#41; 74 hospitales con 2 indicadores mejores y 2 indicadores peores que el promedio&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Hay importantes variaciones interregionales en la frecuentaci&#243;n de ingresos&#44; as&#237; como en las caracter&#237;sticas de la atenci&#243;n de las enfermedades nasosinusales en los hospitales espa&#241;oles&#44; y se han observado 3 patrones definidos de centros en funci&#243;n de sus indicadores de calidad y eficiencia&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe variations in the management of nasosinus disorders among the Autonomous Communities and hospitals of Spain&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We analyzed the Minimum Basic Data Set of the public health system from 1998-2000 for the diagnoses of nasosinus polyps and chronic sinusitis&#46; We studied the distribution by regions of the rate of hospitalizations and of 4 indicators of quality of care and efficiency&#58; mean length of stay&#44; percentage of discharges without surgery&#44; percentage of functional endoscopic sinus surgery and surgical complications&#46; A cluster analysis was performed to classify hospitals according to the values of these indicators&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We analyzed 13061 discharges from 263 hospitals&#46; Marked differences were found in age-adjusted hospitalization rates by regions&#46; Cluster analysis classified the centers with more than 10 annual discharges in 3 categories&#58; a&#41; 32 hospitals in which the 4 quality indicators were above average&#59; b&#41; 35 hospitals in which 3 of the indicators were below average&#44; and c&#41; 74 hospitals in which 2 indicators were above average and 2 indicators were below average&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Marked interregional variations were found in hospitalization rates&#44; as well as in the characteristics of management of nasosinus disorders in Spanish hospitals&#46; The centers examined could be grouped into three clearly defined patterns according to indicators of quality of care and efficiency&#46;</p>"
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ISSN: 02139111
Idioma original: Español
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