[Present and future of nephrology in the hospital based on an analysis of the two-year period 2005-2006].
The activity of nephrologists in the hospital is not limited to kidney disease, as they also have a role as advisors for all those disciplines that treat conditions involving kidney function. An analysis based on discharge reports from nephrology wards of Italian hospitals has been conducted for the last biennium available (2005-2006) in the ministerial database of hospital discharge reports that classifies the main diagnoses into diagnosis-related groups (DRGs) according to a national classification system. All discharges from nephrology wards were defined as nephrological. Taking this first sample as the starting point, further analyses were carried out on the 20 most frequent DRGs identified. The aim was to clarify the position of nephrology within the national hospital activity. The nephrological activity proved to be concentrated on the first four DRGs (59%). The first 20 DRGs accounted for 80% of the total activity, while the remaining 400 DRGs were fragmented, each representing less than 1% of the total activity. Analyzing the same data cross-sectionally, we see that the ''nephrology market'' is ''owned'' by nephrology wards for only 18% of the total. Nephrology does not have a precise position in the hospital activities and shows considerable overlap with general medicine and general surgery (kidney transplants in particular). The Italian DRG classification has no specific nephrological diagnosis group; this could partially explain the fragmentation. An improved classification system could help in identifying a more precise outline of the nephrological activity.
Susi
Alessandra
A
Centro di Ricerche sulla Gestione dell'Assistenza Sanitaria e Sociale (CERGAS), Università Bocconi, Milano. alessandra.susi@unibocconi.it
D005544:Forecasting; D006761:Hospitals; D007558:Italy; D040541:Marketing / Q000706:statistics & numerical data*; D009398:Nephrology / Q000706:statistics & numerical data* / Q000639:trends*; D013997:Time Factors