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Gaceta Sanitaria

versão impressa ISSN 0213-9111

Resumo

CABRERA TORRES, Enrique et al. Outlier patient admissions and their relationship with the emergence of clinical complications and prolonged hospital stays. Gac Sanit [online]. 2019, vol.33, n.1, pp.32-37.  Epub 21-Out-2019. ISSN 0213-9111.  http://dx.doi.org/10.1016/j.gaceta.2017.07.012.

Objective

To analyze the relationship between the type of hospital admission (outlier and non-outlier admissions) and the appearance of clinical complications and the average stay.

Methods

From a retrospective epidemiological study of a cohort of patients admitted to the Hospital Complejo Asistencial Universitario de Salamanca (Salamanca, Spain) over a six-month period, outlier and non-outlier patients were identified. This project had access to the admissions department database, the hospital's CMBD (in Spanish, Conjunto Mínimo Básico de Datos) for hospitalisation, the AP-DRG (All Patient-Diagnosis Related Groups) and ALCOR (a clinical-statistics analytics tool). It then proceeded to break down the results by DRG, looking at the five most common DRGs in that period.

Results

8.4% of the total 11,842 admissions were medical outliers. In the overall study, the average stay was longer for outlier patients (8. 11 days) than for other patients (7.15 days). The mortality rate was, likewise, higher for outlier patients, although there was a reduced incidence of complications (7.6% for outlier patients as opposed to 8.4% for others). The analysis by DRG corroborated these results in three of the five cases investigated, showing longer average stays but fewer clinical complications in the case of outlier patients.

Conclusions

On admission to hospital, a significant proportion of patients were allocated beds on inappropriate wards (outlier patients). It was more common to find medical patients placed on surgical wards than vice versa. The average stay of outlier patients was longer than that of patients admitted to the correct ward. The study found no significant difference between the two groupś in terms of clinical complication rates.

Palavras-chave : Outlier patients; Hospital stays; Complications; Diagnosis related groups; Hospitalisation.

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