How many days of hospitalization for an appendectomy?
The length of stay (LOS) of a surgical procedure is influenced both by the real need for medical and nursing care of the patient and also by the practice style of each unit, which can include unjustified stays. The aim of this work was to estimate the appropriate LOS for appendectomy and its differences with the LOS observed in practice. Two hundred and forty-nine medical records (249 admission days and 1447 successive stays) for patients over 6 years old who had had an appendectomy in 1992 were classified by Diagnosis Related Groups (DRG) and reviewed using the Appropriateness Evaluation Protocol. 1.6% of admission days and 31.7% of successive stays were assessed inappropriate. The appropriate LOS for appendectomy was 4.7 days as opposed to 6.8 days of observed LOS. For the DRG 167 (76.3% of the sample) appropriate LOS was 3.4 days (observed LOS 4.9 days). These results suggest the existence of an important proportion of avoidable hospital stays and provides a simple and low cost methodology for assessing the suitability of local hospitalization practices.
Martínez-Mas
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E
General Surgery Unit, Hospital Arnau de Vilanova, Valencia, Spain.
Peiro
S
S
Meneu
R
R
Roselló-Perez
M L
ML
Portella
E
E
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001062:Appendectomy / Q000145:classification / Q000706:statistics & numerical data; D002648:Child; D015897:Comorbidity; D003953:Diagnosis-Related Groups; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012040:Regional Health Planning; D012189:Retrospective Studies; D013030:Spain