Análisis de las «estancias cero» pediátricas en un hospital de nivel 2 a lo largo de 25 años

Abstract

Introduction

It is essential to admit patients to hospital in an efficient way in order to use resources rationally. Short hospitalary stays are hospitalizations which does not include 00:00 h and are considered avoidable. This study describes trends and characteristics of short stays throughout 25 years in our hospital.

Patients and methods

We analyzed hospital pediatric discharges in a second-level hospital through the registration system «conjunto mínimo básico de datos». We categorized pediatric patients and newborn patients in two groups according to length of hospital stay: «short stays» and «prolonged stays». We analyzed and compared the following variables: gender, age, type of admission, month, diagnosis-related groups (DRG) and admission service. Binary logistic regression analysis and assessment of trends through joinpoint regression analysis were performed.

Results

From 1993 to 2017, 45710 children were admitted to our hospital, of which 7.3% were short stays. The trend analysis showed a point of change upwards–downwards at the beginning of the millennium. Pediatric short stays: the most important variables were emergency admissions (89%), urgent transfers (9%), month December (11%) and main diagnosis category: nervous system (18%). Mean diagnosis-related groups cost was 2432 ± 1115€ in short stays group and 2549 ± 1065€ in prolonged stays.

Conclusions

Short stays and prolonged stays show a falling trend in our hospital. Short stays percentage in our environment is similar to other neighbor countries. Some of our short stays are urgent transfers and admissions for clinical observation. We did not find clinical significance in weight or cost of pediatric patients’ DRG comparing to prolonged stays.