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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 autónomas (CCAA) y hospitales españoles.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analizó el Conjunto Mínimo Básico de Datos del Sistema Nacional de Salud de los años 1998-2000 para los diagnósticos de pólipos nasosinusales y sinusitis crónica. Se estudió la distribución por CCAA de la tasa de hospitalización y de 4 indicadores de calidad asistencial y eficiencia: estancia media, porcentajes de altas sin intervención, técnicas de cirugía endoscópica nasosinusal y complicaciones posquirúrgicas. Se realizó un análisis de conglomerados para clasificar los hospitales según los valores de dichos indicadores.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 13.061 altas de 263 hospitales. Se hallaron importantes diferencias en las tasas de hospitalización ajustadas por edad de diferentes CCAA. El análisis de conglomerados agrupó los centros con más de 10 altas anuales en 3 categorías: a) 32 hospitales con los 4 indicadores de calidad en mejor situación que el promedio; b) 35 hospitales con 3 de los indicadores por debajo del promedio, y c) 74 hospitales con 2 indicadores mejores y 2 indicadores peores que el promedio.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Hay importantes variaciones interregionales en la frecuentación de ingresos, así como en las características de la atención de las enfermedades nasosinusales en los hospitales españoles, y se han observado 3 patrones definidos de centros en función de sus indicadores de calidad y eficiencia.</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.</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. We studied the distribution by regions of the rate of hospitalizations and of 4 indicators of quality of care and efficiency: mean length of stay, percentage of discharges without surgery, percentage of functional endoscopic sinus surgery and surgical complications. A cluster analysis was performed to classify hospitals according to the values of these indicators.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We analyzed 13061 discharges from 263 hospitals. Marked differences were found in age-adjusted hospitalization rates by regions. Cluster analysis classified the centers with more than 10 annual discharges in 3 categories: a) 32 hospitals in which the 4 quality indicators were above average; b) 35 hospitals in which 3 of the indicators were below average, and c) 74 hospitals in which 2 indicators were above average and 2 indicators were below average.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Marked interregional variations were found in hospitalization rates, as well as in the characteristics of management of nasosinus disorders in Spanish hospitals. The centers examined could be grouped into three clearly defined patterns according to indicators of quality of care and efficiency.</p>"
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"nota" => "<p class="elsevierStyleNotepara">Este trabajo es parte de un Proyecto de Evaluación de Tecnologías Sanitarias financiado por el Instituto de Salud Carlos III (exp. 01/10046). El Hospital Costa del Sol es miembro de la Red IRYSS de investigación de resultados en servicios sanitarios.</p>"
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