[CROHN'S DISEASE PATIENTS' SATISFACTION WITH COLONOSCOPY VERSUS ENTERO MAGNETIC RESONANCE IMAGING (MRI)]. / Satisfacción de los pacientes dagnosticados de enfermedad de Crohn con respecto a la colonoscopia y entero-resonancia magnética.

OBJECTIVES: To evaluate satisfaction and preferences in Crohn's disease patients who have undergone a colonoscopy (CL) and a MRI colonography (MRI). As well as evaluate the effectiveness of the information system to collect the data. METHOD: A sectional pilot study conducted through a satisfaction survey questionnaire for patients diagnosed with Crohn's disease (CD). Study patients were selected from the Gastroenterology Department in the Principe de Asturias University Hospital, where both the colonoscopy and the entero magnetic resonance imaging tests were done from the 1st of January to the 30th of June 2012. Surveys were conducted during July and August 2012. RESULTS: A total of 48 patients with Crohn's disease participated. Out of these, 24 were women and 24 were men. The mean age was 43 years (SD: 13.8). The worst score was obtained at the time of preparation for both procedures. If patients could choose they would prefer CL 23, 16 MRI and 9 were indifferent. CONCLUSIONS: The patients' preference for CL could be due to the administration of sedatives prior to the procedure. A procedure such as the CL which initially may result unpleasant for the patient is tolerated much better as a result of the sedation. In both tests, the preparations prior to the procedures are perceived as unpleasant. We will think about how to improve patients' tolerance to these preparations, maybe by giving more information as patients, because we don't know often how to do it properly, which could magnify this unpleasant perception.

[Diseases of the digestive system and a system for patient classification: diagnostic-related groups (DRG)]. / Enfermedades del aparato digestivo y sistema de clasificación de pacientes: grupos relacionados con el diagnóstico (GDR).

In the last years different classification systems for hospitalized patients have been developed in the United States, that allow to evaluate different aspects of any Hospital: The quality, the efficacy and the efficiency. The classification of "The Diagnosis Related Groups" (DRG) relates the hospitalized patients with the expenses that they generate, and it is the most used in Europe. In the version DRG-All Patient, all the diagnoses and procedures of the hospitalized patients, using the International Classification of Diseases, are divided in to 25 Major Diagnostic Categories (MDC) where each one excludes all the others. We describe the behavior with respect to the age, sex and stay of all the GDR integrated in the CDM 6 and 7: diseases and disorders of the digestive tract, and diseases and disorders of the hepatobiliary system and the pancreas. The study has been carried out with a national data base of two millions of cases seen from 214 acute-care Hospitals. The MDC number 6 is the most frequent, with an important number of patients in the pediatric age; it is more frequent in males; the average stay is 8.59 days and 19 GDR (36.5%) have a variation coefficient greater than one. The other MDC, number 7 is less frequent, the majority of the patients are between 60-80 years of age, the average stay is 12.2 days with a coefficient of variation greater than one in 4 GDR (17.4%). Clinical Services should know the characteristics and behavior of their patients, as well as the comparison with the national data bases. This may allow a control of the quality and the costs by using a common "language" with the managers.

[Activity and cost in hospitals managed by INSALUD in 1990-1993]. / Análisis de actividad y gasto en los hospitales del INSALUD de 1990 a 1993.

BACKGROUND: The improvement of the efficiency of the hospitals is a common objective in all the Health Systems. In the last years, different management measures have been implemented in the territory directly managed by Insalud, looking for a continuous improvement of the hospital efficiency. In this paper we analyze the activity and the expenses during the last four years in the Insalud managed hospitals. METHODS: A descriptive study of activity and costs during the last four years has been done in all 88 hospitals and also by groups, using usual indicators of intermediary products and activity and costs measured by UPAs. RESULTS: A global increase of activity is shown: inpatients, outpatients and surgery (above all ambulatory surgery) with a decrease of the average stay and an increase of the rotation index. The activity measured in UPAs has increased in a 2.54% in 1993 compared to 1992 and the UPA cost in constant pesetas has been reduced in 688 pesetas in the same period. The different groups of hospitals are developing a more homogeneous behaviour regarding production indicators as well as costs. CONCLUSIONS: The different management measures implemented in the last years have produced an increase of the activity and of the expenses control leading to less financial increases to perform more hospital activity.