[Variability in hospital care. Nasosinus surgery in Spain].
OBJECTIVE
To describe variations in the management of nasosinus disorders among the Autonomous Communities and hospitals of Spain.


METHODS
We analyzed the Minimum Basic Data Set of the public health system from 1998-2000 for the diagnoses of nasosinus polyps and chronic sinusitis. We studied the distribution by regions of the rate of hospitalizations and of 4 indicators of quality of care and efficiency: mean length of stay, percentage of discharges without surgery, percentage of functional endoscopic sinus surgery and surgical complications. A cluster analysis was performed to classify hospitals according to the values of these indicators.


RESULTS
We analyzed 13061 discharges from 263 hospitals. Marked differences were found in age-adjusted hospitalization rates by regions. Cluster analysis classified the centers with more than 10 annual discharges in 3 categories: a) 32 hospitals in which the 4 quality indicators were above average; b) 35 hospitals in which 3 of the indicators were below average, and c) 74 hospitals in which 2 indicators were above average and 2 indicators were below average.


CONCLUSIONS
Marked interregional variations were found in hospitalization rates, as well as in the characteristics of management of nasosinus disorders in Spanish hospitals. The centers examined could be grouped into three clearly defined patterns according to indicators of quality of care and efficiency.
Jiménez-Puente
Alberto
A
Dirección de Sistemas de Información. Hospital Costa del Sol. Marbella. Málaga.
Piédrola-Maroto
David
D
Perea-Milla
Emilio
E
Lara-Blanquer
Antonio
A
Pons-Palliser
Joana
J
Bandera-Florido
Ana
A
Sarmiento González-Nieto
Víctor
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D012852:Sinusitis / Q000601:surgery*; D013030:Spain; D055815:Young Adult