RESUMO
No disponible
Assuntos
Humanos , Administração de Serviços de Saúde/ética , Administração Sanitária/ética , Acesso aos Serviços de Saúde , Administração de Serviços de Saúde/economia , Administração Sanitária/economia , Médicos/ética , Acesso aos Serviços de Saúde/organização & administração , Médicos/organização & administraçãoRESUMO
OBJECTIVE: To evaluate variations in the observation period in the emergency department (ED) in response to bed availability. METHODS: A quasi-experimental pre-test post-test study without a control group was conducted in the ED observation ward over 2 1-month periods. During this time the only variable that changed was the number of beds available, which decreased from 20 (pre-test period) to 16 (post-test period). RESULTS: The ED attended 7,725 patients: 3,706 patients in pre-test period, 335 of whom were admitted to the observation ward, with an average length of stay of 1,105.4 minutes per patient, and 4,019 patients in post-test period, 570 of whom were admitted to the observation ward, with an average length of stay of 686.1 minutes per patient (p < 0.001). There was no variation in mortality, re-admissions or complaints. CONCLUSIONS: A reduction in bed availability for observation purposes shortens patient length of stay.
Assuntos
Tomada de Decisões , Serviço Hospitalar de Emergência/organização & administração , Recursos em Saúde , MédicosRESUMO
Objetivo: Evaluar la variación del indicador "periodo de tiempo de observación" dedicado a cada paciente, en respuesta a una reducción del número de camas disponibles. Métodos: Se realizó un estudio «quasiexperimental preprueba postprueba» sin grupo control en una unidad de urgencias durante 2 períodos de un mes. En este tiempo el único cambio fue el número de camas disponibles, que disminuyeron de 20 (período A) a 16 (período B). Resultados: El servicio de urgencias atendió a 7.725 pacientes: 3.706 pacientes en el período A, 335 de los cuales fueron admitidos en la unidad de observación con una estancia media de 1.105,4 minutos por paciente; y 4.019 pacientes en el período B, 570 de los cuales fueron admitidos en la unidad de observación con una estancia media de 686,1 minutos por paciente (p < 0,001). No hubo variaciones en la mortalidad, readmisiones o quejas. Conclusiones: Una disminución en el número de camas disponibles para observación comporta una reducción en el tiempo de estancia de los pacientes
Objective: To evaluate variations in the observation period in the emergency department (ED) in response to bed availability. Methods: A quasi-experimental pre-test post-test study without a control group was conducted in the ED observation ward over 2 1-month periods. During this time the only variable that changed was the number of beds available, which decreased from 20 (pre-test period) to 16 (post-test period). Results: The ED attended 7,725 patients: 3,706 patients in pre-test period, 335 of whom were admitted to the observation ward, with an average length of stay of 1,105.4 minutes per patient, and 4,019 patients in post-test period, 570 of whom were admitted to the observation ward, with an average length of stay of 686.1 minutes per patient (p < 0.001). There was no variation in mortality, re-admissions or complaints. Conclusions: A reduction in bed availability for observation purposes shortens patient length of stay
Assuntos
Humanos , Observação , Admissão do Paciente/estatística & dados numéricos , Serviços Médicos de Emergência/estatística & dados numéricos , Garantia da Qualidade dos Cuidados de Saúde/métodos , Tempo de Internação/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricosRESUMO
En este artículo los autores revisan las características específicas de la investigación en las especialidades quirúrgicas, sus problemas y diferencias en relación al resto de la investigación biomédica. Hacen especial hincapié en los temas más frecuentes a investigar en cirugía, sus defectos y la metodología. Argumentan que los estudios prospectivos randomizados a doble ciego no deben ser sobredimensionados, ya que presentan problemas metodológicos y bioéticos al aplicarlos a la cirugía. Los estudios prospectivos son los más utilizados por los cirujanos para el avance de las especialidades quirúrgicas (AU)
In this article authors review the specific characteristics of surgical research. Its problems and differences from other biomedical research. Specially they specify the main topics for surgical investigation, its pitfalls and methodologies. They argue that randomised prospective double blind studies must not be over dimensioned, as for surgery they present many difficulties, specially ethical and practical. Prospective studies are been more used by surgeons for the advance of the different surgical specialities (AU)
Assuntos
Humanos , Pesquisa Biomédica/tendências , /tendências , Especialidades Cirúrgicas/tendências , Modelos Animais de Doenças , Estudos ProspectivosRESUMO
No disponible
