[Information needs of patients in primary care from the perspective of health professionals. A Delphi study]. / Necesidades de información de los usuarios de Atención Primaria desde la perspectiva de los profesionales sanitarios. Un estudio Delphi.

OBJECTIVE: To determine the information needed by patients in relation to the supply of primary care services from the perspective of health professionals. METHODS: The Delphi technique was used as a consensus method. Seventy experts were asked to participate: 35 primary care physicians, 32 nurse practitioners, and three pediatricians in rural and non-rural health centers in the Health Area of Salamanca between May and December 2006. The questionnaires used were structured into six sections: patients' knowledge of their health, services in their health centers, administrative topics, the media, information expectations, and communication barriers. In the third questionnaire, prioritized answers were scored between 5 points and 1 point according to their importance. RESULTS: All three questionnaires were completed by 44 experts (62.8%). The information needs with the highest scores were information on patients' diseases (4.0 points), subjects related to patients' responsibility for their health (3.8) and preventive advice (3.6), followed by subjects relating to access (4.2), emergencies (3.4), physicians' and nurse practitioners' services (3.6), and places to go to get information (4.0). The lack of coordination between primary and hospital care (4.1) and excessive bureaucracy (3.5) were considered to limit communication and information. CONCLUSIONS: The factors identified focus on contents that allow patients to get involved in their own process and to take active part in the decision-making that concerns them. Other important factors were information about services and the access to them.

[Outlier patient admissions and their relationship with the emergence of clinical complications and prolonged hospital stays]. / Los ingresos ectópicos y su relación con la aparición de complicaciones y estancias prolongadas.

OBJECTIVE: To analyze the relationship between the type of hospital admission (outlier and non-outlier admissions) and the appearance of clinical complications and the average stay. METHODS: From a retrospective epidemiological study of a cohort of patients admitted to the Hospital Complejo Asistencial Universitario de Salamanca (Salamanca, Spain) over a six-month period, outlier and non-outlier patients were identified. This project had access to the admissions department database, the hospital's CMBD (in Spanish, Conjunto Mínimo Básico de Datos) for hospitalisation, the AP-DRG (All Patient-Diagnosis Related Groups) and ALCOR (a clinical-statistics analytics tool). It then proceeded to break down the results by DRG, looking at the five most common DRGs in that period. RESULTS: 8.4% of the total 11,842 admissions were medical outliers. In the overall study, the average stay was longer for outlier patients (8. 11 days) than for other patients (7.15 days). The mortality rate was, likewise, higher for outlier patients, although there was a reduced incidence of complications (7.6% for outlier patients as opposed to 8.4% for others). The analysis by DRG corroborated these results in three of the five cases investigated, showing longer average stays but fewer clinical complications in the case of outlier patients. CONCLUSIONS: On admission to hospital, a significant proportion of patients were allocated beds on inappropriate wards (outlier patients). It was more common to find medical patients placed on surgical wards than vice versa. The average stay of outlier patients was longer than that of patients admitted to the correct ward. The study found no significant difference between the two groups in terms of clinical complication rates.