[Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].
OBJECTIVE
Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness.


METHODS
Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed.


RESULTS
542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (p<0.05). The readmission rate was similar in the 2 groups (5.5% and 6.5%, respectively). The results per each DRG group were similar to the overall results.


CONCLUSIONS
For a similar case mix, hospitalization in IMID departments had a positive influence on the variables analyzed as compared to hospitalization in other departments, with a shorter mean stay, lower mortality, and lower mean DRG-based economic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.
Gómez
Joaquín
J
Servicio de Medicina Interna-Infecciosas, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España.
García-Vázquez
Elisa
E
Antonio Puertas
José
J
Ródenas
Julio
J
Herrero
José Antonio
JA
Albaladejo
Carmen
C
Baños
Víctor
V
Canteras
Manuel
M
Alcaraz
Manolo
M
D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data; D006748:Hospital Departments / Q000191:economics / Q000458:organization & administration*; D017052:Hospital Mortality; D006769:Hospitals, General / Q000191:economics / Q000458:organization & administration*; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D055552:Infectious Disease Medicine / Q000191:economics / Q000458:organization & administration*; D007388:Internal Medicine / Q000191:economics / Q000458:organization & administration*; D012141:Respiratory Tract Infections / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D018805:Sepsis / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D012874:Skin Diseases, Infectious / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D013030:Spain / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000191:economics / Q000453:epidemiology / Q000628:therapy