Hospital utilization of medical specialties

Abstract

Objectives: Inadequate incomes in the hospitals of the world remains existing problem after three decades of implementation of the Protocol of evaluation of adequacy (ASP) that uses explicit criteria to assess whether hospitalization is adequate or inadequate. The specialty of the doctor has become an important associated factor to inadequate income. To determine the medical specialties that generates most frequently inadequate hospitalizations.

Material and methods: Observational, descriptive, and transversal study at Dos de Mayo National Hospital, Lima-Peru. A systematic sample of 372 emergency hospital admissions for a total of 9917 admissions in the period of 2006-2007 was reviewed. Variables such as age, sex, place of origin, mode of entry and specialty of the doctor indicating the hospitalization were collected. The results were expressed in absolute and relative frequencies and mean distribution (+1SD). The quantitative variables were studied by T student test for independent samples. For comparison of proportions, Chi-square was used.

Results: 33.60% of medical admissions made in the medical services were inadequate. Medical specialties most frequently associated with inadequate hospitalizations were general medicine (92%), Gastroenterology (71.43%) and Hematology (62.50%).

Conclusions: The specialty of physician ordering the hospital medicine services was a risk factor for generating an improper admission and therefore inefficient and inadequate hospital use.