Surgical and anesthesiological procedures and patients outcome in a major teaching hospital, in a major non-teaching hospital and in a minor hospital.
OBJECTIVE
This study was carried out to evaluate the outcome of patients in different hospitals with the aim to plan future structural and management changes.


METHODS
All the anaesthesiological and surgical procedures were observed for a 2 weeks period in a major teaching hospital (A), in a major nonteaching hospital (B) and in a minor nonteaching hospital (C) in all the patients requiring anaesthesia. The main and the co-existing diseases and the surgical and anaesthesiological treatments they received were evaluated to determine the outcome. The ASA class, the duration of the procedure, the length of staying in hospital, the transfusions of blood or derivatives, the adverse events for each patient were also observed.


RESULTS
The results showed that the patients admitted to the teaching hospital were classified in higher ASA risk classes and had surgery of longer duration, with a higher ratio of major surgery. The outcome was satisfactory in all the 3 hospitals, with a 2 days length of stay respectively in 30% (A and B) and 50% (C) of the patients. The rate of mortality was low: only 3 patients in hospital A and no patient in B and C died in a period of 2 days following surgery. Hospitals B and C showed a large use of modern techniques such as autologous blood transfusion and central and peripheral anaesthetic blocks, with a better cost-benefit ratio than the major teaching hospital.


CONCLUSIONS
This study showed good results, but it should be repeated in a few years in order to evaluate any change and possible improvement in the management and outcome of the patients.
Anesthesia and Intensive Care Unit, Azienda Ospedaliera Consorziale Policlinico, Bari, Italy. g.barbone@libero.it
G
G
Barbone
N
N
Oreste
R
R
Pagliarulo
P
P
Verrastro
O
O
Stanzione
P
P
Dormio
T
T
Fiore
D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000009:adverse effects; D005260:Female; D006276:Health Facility Size; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011787:Quality of Health Care; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D016896:Treatment Outcome