title: [Adequacy of the admissions and care provided to the patients with community-acquired pneumonia].
abstract: BACKGROUND
  The purpose of this study has been to know the adequacy of the hospital admissions of patients with community-acquired pneumonia (CAP), applying the Fine Modified Forecast Classification Rule and if patient care is performed in accordance with the indicators for quality by the Infectious Diseases Society of America (IDSA) recommendations.
  
  
  METHODS
  A cross-sectional and retrospective study analyzing the appropriateness of hospital admissions of all patients treated for CAP at the Hospital Clínico Universitario de Valladolid during 2006. All patients were interviewed with the classification rules for Fine Modified Forecasting to evaluate the adequacy of hospital admissions through the analysis of associated comorbidity, severity parameters and quality indicators.
  
  
  RESULTS
  We detected 23 cases (6.07%) of CAP inadequately admitted, 5 of whom were Class I (21.7%), 10 Class II (43.4%) and 8 Class III (34.7%). COPD (32.5%) and hypoxemia (36%) were the comorbidities and risk factors most involved in the admission of low-risk CAP. A total of 25 (32.89%) inadequate discharges were observed from the Emergency Service and the following was found in regard to their Pneumonia Severity Index (PSI): Class I: 2 (8%), Class II: 10 (40%) Class III: 7 (28%), Class IV: 4 (16%), Class V: 0; Fine Unknown: 2. The most important comorbidity in inadequate discharges was 10 for COPD (40%). The following were performed: blood cultures in 160 cases (42.2%), chest x-ray in 379 (100%), gas and/or pulse measurement in 379 (100%), and measurement of Ag S. pneumoniae and Legionella in urine in 14 (87.5%) of the 16 cases of CAP that required admission to the ICU.
  
  
  CONCLUSIONS
  The Fine Modified Forecasting Classification Rule can be very useful in assessing adequacy of admissions and to decide the need for hospital admission due to CAP. Adequate care for patients with CAP according to the quality indications established by the IDSA stands out.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España. hinojosac@teleline.es
authors.forename: J
authors.initials: J
authors.lastname: Hinojosa Mena-Bernal
authors.forename: C
authors.initials: C
authors.lastname: Hinojosa Mena-Bernal
authors.forename: E
authors.initials: E
authors.lastname: González Sarmiento
authors.forename: A
authors.initials: A
authors.lastname: Almaráz Gómez
authors.forename: S
authors.initials: S
authors.lastname: Martín Santos
authors.forename: A
authors.initials: A
authors.lastname: Zapatero Gaviria
mesh_terms: D000368:Aged; D000465:Algorithms; D017714:Community-Acquired Infections / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000592:standards*; D011014:Pneumonia / Q000628:therapy*; D011787:Quality of Health Care; D012189:Retrospective Studies