Abstract

RAMOS RINCON, J. M. et al. Mortality rate by DRG and by the principal diagnosis according the ICD-9-CM in a II level hospital of INSALUD of Murcia during 1999. An. Med. Interna (Madrid) [online]. 2001, vol.18, n.10, pp.14-24. ISSN 0212-7199.

Introduction: The inhospital mortality is a marker of health care quality. It can be evaluated according by the principal diagnosis of disease or by Diagnosis Related Groups (DRG).  Objectives: know and to analyze the inhospital mortality and mortality rate (MR) in the patients admitted in the Hospital Morales Meseguer (Murcia) of II level of the INSALUD during 1999.  Methodology: Study of the minimum basic group of data into the hospital.  Results: The MR was 3.8% of 508 deaths analyzes, 56.7% corresponded a male. The MR was equal in male (3.6%) and females (3.9%). The medium of age into deaths was 77 years. The numbers of deaths in-patients under 80 years was higher in males (n=197; 65%) than in lower in female (n=102; 35%)(p=0.002). The addition of deaths of Internal Medicine and Intensive Care Unit represent a 70% of cases of deaths occurred in the hospital. The MR was higher in Intensive Care Unit (10.5%) followed by Hematology (6.9%) and Internal Medicine (6.1%). Ten DRG represents of 50% of the causes of deaths, and all of them were DRG of medical categories. The DRG more frequents was 541, Respiratory disorders with complication (n=61, MR 12.8%), followed by DRG 533, Specific cerebrovascular disorders without Transit isquemic accident (n=33; MR 34.7%), DRG 123 Acute myocardical infarction (AMI) with death (n=31; MR100%), DRG 014 Others disorders of nervous system (n= 27; TM: 10.3%) y DRG 552 Disorders of digestive tract without esophagitis, gastroenteritis and not complicated ulcer (n=27; MR: 31.0). The main diagnostic more frequent was cerebrovascular diseases (n=60, MR12.2%), pneumonia-bronchopneumonia (n= 52, MR 10.9%), chronic obstructive lung disease (n=36, MR 7.1%), AMI (n=33, MR 11.5%), and neoplasia of digestive tract (n=26; MR 8.5%). The MR of woman with AMI (19.5%) was higher than man (7.7%) (p=0.005), the MR in woman with abdominal hernia (4.3%) was higher than man (0.6%) (p=0.01), and MR of pyelonephritis and urinary infection in man (4.9%) was higher than woman (0%) (p=0.008).  Conclusions: The mortality and MR by DRG and main diagnostic is an indicator than permit to know and monitoring the quality of health care.

Keywords : Inhospital mortality; Diagnosis realated groups; Main diagnostic; Quality control.

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