RESUMEN
INTRODUCTION: Although timely hospital discharge is a complex and multifactorial process, this metric is consistently a focus for hospitals and health care systems. It also has been a long practice that the American Urological Association (AUA) supports the use of advanced practice providers (APPs) as an integral member of the urological care team. MATERIALS AND METHODS: Here, we performed a preliminary evaluation of the effectiveness of an inpatient APP in reducing hospital length of stay (LOS) following major urologic oncology procedures. Surgical outcomes, surgeon data, and LOS for open and minimally invasive urologic oncology procedures, including radical prostatectomy, partial or radical nephrectomy, and radical cystectomy, were compiled over a 4-year period (pre-APP: 2014-2016 and post-APP: 2018-2020). Univariate descriptive statistics analyzed the association of an inpatient APP in with reducing hospital LOS over time. RESULTS: Average LOS decreased in all surgical procedures and for all surgeons in the post-APP setting, irrespective of surgical approach (P< 0.05). CONCLUSIONS: An inpatient APP was associated with a decrease of hospital LOS for urologic oncology patients over time. Such observations underscore the likely economic benefit to the health care system and potential improved coordination of care and satisfaction for patients undergoing major urologic oncology procedures.
Asunto(s)
Cistectomía , Pacientes Internos , Hospitales , Humanos , Tiempo de Internación , Masculino , NefrectomíaRESUMEN
There are several descriptive studies of the use of mental health Services in the population served in the public system, however there are few references concerning the private system. Objective: To characterize a population with GES mental health pathology admitted in private mental health system in relation to the length of stay. Material and Methods: Medical charts were reviewed for 1,544 patients discharged from hospital admissions in private mental health centers. The following variables were recorded: age at diagnosis, sex, length of stay, number of hospitalizations and multiaxial diagnosis. Results: The average hospital stay for the sample was 21.05 days. The average hospital stay of men was 3.71 ± 2.46 days more than average women (p = 0.05). The average LOS was higher in younger patients. With regards to axis I, 68.52% of patients had severe major depression, 21.87% bipolar disorder in severe depressive phase and 6.87% schizophrenia. Axis I comorbidity was present in 17.94% of the sample. For Axis II, 57.97% of patients had personality disorders, with the borderline personality being the most frequent in both sexes (51.06% of patients with disorder of personality). The analysis of information shows that comorbidities did not significantly influence average days of hospitalization. Conclusions: This study is contributes to estimate the costs and the average stay in inpatient GES mental health patients in the private system.
Existen diversos estudios descriptivos del uso de servicios de Salud Mental en la población atendida en el sistema público, sin embargo, se encuentran pocas referencias respecto al sistema privado. Objetivo: Caracterizar a una población con patología de salud mental GES internada en centros privados de salud mental en relación a los días de hospitalización. Material y Método: Se revisaron 1.544 fichas de pacientes egresados de hospitalizaciones en centros privados de salud mental registrando las siguientes variables: edad al momento del diagnóstico, sexo, días de hospitalización, número de hospitalizaciones y diagnóstico según eje. Resultados: El promedio de días de hospitalización de la muestra fue de 21,05 días. El promedio de días de hospitalización de los hombres fue 3,71 ± 2,46 días mayor que el promedio de las mujeres (p = 0,05). El promedio de días de hospitalización fue más alto en los pacientes jóvenes. En el eje I, el 68,52% de los pacientes presentaron patología del ánimo en su forma monopolar; 21,76% patología del ánimo en su forma bipolar y un 6,87% fueron diagnosticados con esquizofrenia. La comorbilidad en el eje I se presentó en un 17,94% de la muestra. Respecto al eje II, el 57,97% presenta algún trastorno de la personalidad, siendo el trastorno de personalidad limítrofe el más frecuente en ambos sexos (51,06% del total de pacientes con trastorno de la personalidad). Del análisis de la información destaca que las comorbilidades no influyeron de forma significativa en el promedio de los días de hospitalización. Conclusiones: Este estudio constituye un aporte para estimar los costos y la estadía promedio en una hospitalización de pacientes GES de salud mental en el sistema privado.