Características y costes de los pacientes ingresados por arritmias cardiacas en España

Santiago, Julio Montes; Rodil, V.; Formiga, Francesç; Cepeda, J.M.; Urrutia, Agustín

doi:10.1016/j.rce.2013.02.003

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…The DRG system attributes a relative weight to each DRG based on its cost, with the value of 1 representing the mean global cost. In Spain, these weights and costs are derived from information on hospital care costs obtained by the hospital accounting systems [21,22]. Moreover, the DRG system assigns a severity and mortality risk according to all patient refined diagnosis-related groups (APR-DRG) used to label patients in the minimum data set from low (level 1) to extreme (level 4).…”

Section: Plos Onementioning

confidence: 99%

Care complexity individual factors associated with adverse events and in-hospital mortality

et al. 2020

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Introduction Measuring the impact of care complexity on health outcomes, based on psychosocial, biological and environmental circumstances, is important in order to detect predictors of early deterioration of inpatients. We aimed to identify care complexity individual factors associated with selected adverse events and in-hospital mortality. Methods A multicenter, case-control study was carried out at eight public hospitals in Catalonia, Spain, from January 1, 2016 to December 31, 2017. All adult patients admitted to a ward or a step-down unit were evaluated. Patients were divided into the following groups based on the presence or absence of three adverse events (pressure ulcers, falls or aspiration pneumonia) and in-hospital mortality. The 28 care complexity individual factors were classified in five domains (developmental, mental-cognitive, psycho-emotional, sociocultural and comorbidity/complications). Adverse events and complexity factors were retrospectively reviewed by consulting patients' electronic health records. Multivariate logistic analysis was performed to identify factors associated with an adverse event and in-hospital mortality. Results A total of 183,677 adult admissions were studied. Of these, 3,973 (2.2%) patients experienced an adverse event during hospitalization (1,673 [0.9%] pressure ulcers; 1,217 [0.7%] falls and 1,236 [0.7%] aspiration pneumonia). In-hospital mortality was recorded in 3,996 patients (2.2%). After adjustment for potential confounders, the risk factors independently associated with both adverse events and in-hospital mortality were: mental status impairments, impaired adaptation, lack of caregiver support, old age, major chronic disease, hemodynamic instability, communication disorders, urinary or fecal incontinence, vascular

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Section: Plos Onementioning

confidence: 99%

Care complexity individual factors associated with adverse events and in-hospital mortality

et al. 2020

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“…To our knowledge, this is the first study in Spain that has quantified the social value generated by the implementation of a set of proposals to improve the current HF approach in the SNHS. Until now, the expenses related to the management of HF have only been studied in terms of tangible costs, without showing a complete overview of their impact on patients' lives, their informal caregivers, and the society. There is no exact method to capture the social value, but the traditional ones leave out of the analysis its total impact.…”

Section: Discussionmentioning

confidence: 99%

The social return on investment of a new approach to heart failure in theSpanish National Health System

et al. 2020

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Aims We aim to agree on a set of proposals to improve the current management of heart failure (HF) within the Spanish National Health System (SNHS) and apply the social return on investment (SROI) method to measure the social impact that these proposals would generate. Methods and results A multidisciplinary working team of 16 experts was set up, with representation from the main stakeholders regarding HF: medical specialists (cardiologists, internal medicine physicians, general practitioners, and geriatric physicians), nursing professionals, health management professionals, patients, and informal caregivers. This team established a set of proposals to improve the management of HF according to the main areas of HF care: emergency and hospitalization, primary care, cardiology, and internal medicine. A forecast‐type SROI method, with a 1‐year time frame, was applied to measure the social impact resulting from the implementation of these proposals. The required investment and social return were estimated and summarized into a ratio indicating how much social return could be generated for each euro invested. Intangible returns were included and quantified through financial proxies. The approach to improve the management of HF consisted of 28 proposals, including the implementation of a case management nurse network, standardization of operational protocols, psychological support, availability of echocardiography machines at emergency departments, stationary units and primary care, early specialist visits after hospital discharge, and cardiac rehabilitation units, among others. These proposals would benefit not only patients and their informal caregivers but also the SNHS. Regarding patients, proposals would increase their autonomy in everyday activities, decrease anxiety, increase psychological and physical well‐being, improve pharmacological adherence and self‐care, enhance understanding of the disease, delay disease progression, expedite medical assessment, and prevent the decrease in work productivity associated with HF management. Regarding informal caregivers, proposals would increase their quality of life; improve their social, economic, and emotional well‐being; and reduce their care burden. The SNHS would benefit from shorter stays of HF patients at intensive care units and reduction of hospitalizations and admissions to emergency departments. The investment needed to implement these proposals would amount to €548m and yield a social return of €1932m, that is, €3.52 for each euro invested. Conclusions The current management of HF could be improved by a set of proposals that resulted in an overall positive social return, varying between areas of analysis. This may guide the allocation of healthcare resources and improve the quality of life of patients with HF.

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“…In addition, AF contributes to the increased morbidity and mortality of other common conditions such as stroke [6], Heart Failure (HF) [ 7,8] and systemic embolism. Therefore, AF is a serious and expensive public health problem [5,8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with NVAF who are admitted to a hospital are most frequently admitted to internal medicine units [9][10][11][12]. These patients have distinct characteristics from those seen in primary care units [3,11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antithrombotic therapy and clinical characteristics of patients hospitalized for nonvalvular atrial fibrillation in Galician internal medicine clinics

González¹,

Fernandez-Bouza²,

Reboiro³

et al. 2019

J Cardiovasc Med Cardiol

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Highlights • Patients with nonvalvular atrial fi brillation (NVAF) admitted to the internal medicine units of Galician hospitals were generally elderly (mean age 80 years) patients with complex comorbidities who were taking multiple medications • Most patients with NVAF were admitted to hospital for reasons other than NVAF (72.5%) • The most common causes of hospital admission in NVAF patients were heart failure and respiratory conditions • 75.1% of NVAF patients were taking anticoagulants at the time of admission.

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Características y costes de los pacientes ingresados por arritmias cardiacas en España

Cited by 12 publications

References 16 publications

Care complexity individual factors associated with adverse events and in-hospital mortality

Care complexity individual factors associated with adverse events and in-hospital mortality

The social return on investment of a new approach to heart failure in theSpanish National Health System

Antithrombotic therapy and clinical characteristics of patients hospitalized for nonvalvular atrial fibrillation in Galician internal medicine clinics

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