Internal Transfers – Internal Medicine Department evaluation in a Central Hospital
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://revista.spmi.pt/index.php/rpmi/article/view/1741 |
Resumo: | Introduction and Objectives – Coimbra´s University Hospital has a significant rate of Internal Transfers (IT). The authors analysed this parameter in the Internal Medicine department - Service II with the objective of evaluating the departments’ interface, namely resource utilisation and cooperation with other departments of the same Hospital.Material and methods – Amongst the admissions to the Internal Medicine department - Service II, the ones with a discharge date between the January 1st 2000 and December 31st 2001 were selected. General indicators and indication for transfer were studied, particularly the subgroups involving transfers to the Intensive Care Unit (ICU) and Surgical procedures (Cir). The economic impact was quantified using relative weight methodology and financial determinations were based on the Diagnosis Related Groups (DRG).Results – The number of IT episodes was 154 (6.3 % of the admissions to the Internal Medicine department - Service II). The mortality rate was 16.2 % and the average length of admission was 27.7 days (higher than the Internal Medicine department – Service II general average – 8.9 % and 8.7 days). The most significant IT target department from the Internal Medicine department – Service II was General Surgery (34 %). On the other hand, the ICU showed the highest rate of IT (4.8 %) to the Internal Medicine department – Service II. The subgroups involving Surgery (n=53; 34.4 %) and ICU (n=43; 27.9 %) showed a different profile from the overall number of transfers, namely the admission days attributed to the Internal Medicine department – Service II of the ICU patients (n=431) and urgent surgery (n=24). The impact on the DRG financial reimbursement in the IT group was significant.Conclusions – The authors outline some aspects of the analysis: 1. The IT corresponded to a more differentiated care group; 2. The importance of the post-ICU care group in the overall results signalled the need for human and material resources adequate for proper care of these patients; 3. The existence of non-programmed surgery as a point of interest, namely the need for accurate identification in the emergency room of the cases with surgical indication; 4. The importance of the IT parameter in the model for financial evaluation of the Integrated Responsibility Centres (IRC). |
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Internal Transfers – Internal Medicine Department evaluation in a Central HospitalTransferências internas — Avaliação num Serviço de Medicina de um Hospital CentralTransferências internasgrupo de diagnósticos homogéneos (GDH)Internal transferencesdiagnosis related groups (DRG) mortalityIntroduction and Objectives – Coimbra´s University Hospital has a significant rate of Internal Transfers (IT). The authors analysed this parameter in the Internal Medicine department - Service II with the objective of evaluating the departments’ interface, namely resource utilisation and cooperation with other departments of the same Hospital.Material and methods – Amongst the admissions to the Internal Medicine department - Service II, the ones with a discharge date between the January 1st 2000 and December 31st 2001 were selected. General indicators and indication for transfer were studied, particularly the subgroups involving transfers to the Intensive Care Unit (ICU) and Surgical procedures (Cir). The economic impact was quantified using relative weight methodology and financial determinations were based on the Diagnosis Related Groups (DRG).Results – The number of IT episodes was 154 (6.3 % of the admissions to the Internal Medicine department - Service II). The mortality rate was 16.2 % and the average length of admission was 27.7 days (higher than the Internal Medicine department – Service II general average – 8.9 % and 8.7 days). The most significant IT target department from the Internal Medicine department – Service II was General Surgery (34 %). On the other hand, the ICU showed the highest rate of IT (4.8 %) to the Internal Medicine department – Service II. The subgroups involving Surgery (n=53; 34.4 %) and ICU (n=43; 27.9 %) showed a different profile from the overall number of transfers, namely the admission days attributed to the Internal Medicine department – Service II of the ICU patients (n=431) and urgent surgery (n=24). The impact on the DRG financial reimbursement in the IT group was significant.Conclusions – The authors outline some aspects of the analysis: 1. The IT corresponded to a more differentiated care group; 2. The importance of the post-ICU care group in the overall results signalled the need for human and material resources adequate for proper care of these patients; 3. The existence of non-programmed surgery as a point of interest, namely the need for accurate identification in the emergency room of the cases with surgical indication; 4. The importance of the IT parameter in the model for financial evaluation of the Integrated Responsibility Centres (IRC). Introdução e Objectivos – Os Hospitais da Universidade de Coimbra têm um elevado índice de transferências internas (TI). Neste contexto, os autores avaliaram este parâmetro no internamento do Serviço de Medicina II, tendo como objectivo a avaliação da interface com os restantes Serviços, nomeadamente a colaboração e complementaridade de recursos.Material e Métodos – Nos internamentos com menção ao Serviço de Medicina II, tendo data de alta do hospital entre 01-01-2000 e 31-12-2001, seleccionaram-se para estudo o grupo com TI. Foram avaliados os indicadores gerais deste grupo, o sentido das transferências, incluindo a discriminação dos serviços envolvidos, estudando em particular os subgrupos com menção a unidade de cuidados intensivos (UCI) e a intervenção cirúrgica (Cir), avaliando o impacto económico destes episódios, com determinação do peso relativo e o financiamento por Grupos de Diagnósticos Homogéneos (GDH).Resultados – O número de episódios com TI foi de 154, correspondendo a 6,3% dos internamentos do Serviço. Nestes destacam a mortalidade de 16,2% e a demora média de 27,7 dias, superiores às totais do Serviço, 8,9% e 8,7 dias. Nas transferências de Medicina II para outro Serviço, a área mais envolvida foi a Cirurgia Geral (34%); no sentido contrário as UCI foram a primeira área (48,8%). Os subgrupos com Cir (n=53; 34,4%) e com UCI (n=43; 27,9%) mostraram características diferentes do total das transferências, sendo relevante o número de dias em Medicina II dos doentes com UCI (n=431) e as intervenções urgentes (n=24). Registaram-se diferenças de financiamento por GDH entre o grupo TI e o reagrupamento só com os procedimentos realizados em Medicina II.Conclusões – Destacam-se alguns aspectos do estudo: 1. Os episódios com TI constituíram um grupo caracterizado por cuidados mais diferenciados; 2. O peso na continuidade pós UCI alerta para a necessidade do serviço ter meios humanos e materiais adequados para o apoio ao doente transferido das UCI; 3. A presença de intervenções cirúrgicas não programadas como ponto de interesse, devendo merecer especial atenção, principalmente na avaliação no Serviço de Urgência dos casos cirúrgicos, os quais, muitas vezes, não são identificados, levando ao internamento em Serviços de Medicina Interna; 4. Interesse do índice de TI na avaliação do modelo de financiamento dos Serviços.Sociedade Portuguesa de Medicina Interna2004-06-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://revista.spmi.pt/index.php/rpmi/article/view/1741Internal Medicine; Vol. 11 No. 2 (2004): Abril/ Junho; 62-69Medicina Interna; Vol. 11 N.º 2 (2004): Abril/ Junho; 62-692183-99800872-671Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spmi.pt/index.php/rpmi/article/view/1741https://revista.spmi.pt/index.php/rpmi/article/view/1741/1204Carrola, PauloParente, FranciscoDuarte, ManuelaDevesa, NunoDias, PatríciaAlexandrino, M. B.Moura, J. J.info:eu-repo/semantics/openAccess2023-04-01T06:11:29Zoai:oai.revista.spmi.pt:article/1741Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:48:16.697385Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital Transferências internas — Avaliação num Serviço de Medicina de um Hospital Central |
title |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital |
spellingShingle |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital Carrola, Paulo Transferências internas grupo de diagnósticos homogéneos (GDH) Internal transferences diagnosis related groups (DRG) mortality |
title_short |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital |
title_full |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital |
title_fullStr |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital |
title_full_unstemmed |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital |
title_sort |
Internal Transfers – Internal Medicine Department evaluation in a Central Hospital |
author |
Carrola, Paulo |
author_facet |
Carrola, Paulo Parente, Francisco Duarte, Manuela Devesa, Nuno Dias, Patrícia Alexandrino, M. B. Moura, J. J. |
author_role |
author |
author2 |
Parente, Francisco Duarte, Manuela Devesa, Nuno Dias, Patrícia Alexandrino, M. B. Moura, J. J. |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Carrola, Paulo Parente, Francisco Duarte, Manuela Devesa, Nuno Dias, Patrícia Alexandrino, M. B. Moura, J. J. |
dc.subject.por.fl_str_mv |
Transferências internas grupo de diagnósticos homogéneos (GDH) Internal transferences diagnosis related groups (DRG) mortality |
topic |
Transferências internas grupo de diagnósticos homogéneos (GDH) Internal transferences diagnosis related groups (DRG) mortality |
description |
Introduction and Objectives – Coimbra´s University Hospital has a significant rate of Internal Transfers (IT). The authors analysed this parameter in the Internal Medicine department - Service II with the objective of evaluating the departments’ interface, namely resource utilisation and cooperation with other departments of the same Hospital.Material and methods – Amongst the admissions to the Internal Medicine department - Service II, the ones with a discharge date between the January 1st 2000 and December 31st 2001 were selected. General indicators and indication for transfer were studied, particularly the subgroups involving transfers to the Intensive Care Unit (ICU) and Surgical procedures (Cir). The economic impact was quantified using relative weight methodology and financial determinations were based on the Diagnosis Related Groups (DRG).Results – The number of IT episodes was 154 (6.3 % of the admissions to the Internal Medicine department - Service II). The mortality rate was 16.2 % and the average length of admission was 27.7 days (higher than the Internal Medicine department – Service II general average – 8.9 % and 8.7 days). The most significant IT target department from the Internal Medicine department – Service II was General Surgery (34 %). On the other hand, the ICU showed the highest rate of IT (4.8 %) to the Internal Medicine department – Service II. The subgroups involving Surgery (n=53; 34.4 %) and ICU (n=43; 27.9 %) showed a different profile from the overall number of transfers, namely the admission days attributed to the Internal Medicine department – Service II of the ICU patients (n=431) and urgent surgery (n=24). The impact on the DRG financial reimbursement in the IT group was significant.Conclusions – The authors outline some aspects of the analysis: 1. The IT corresponded to a more differentiated care group; 2. The importance of the post-ICU care group in the overall results signalled the need for human and material resources adequate for proper care of these patients; 3. The existence of non-programmed surgery as a point of interest, namely the need for accurate identification in the emergency room of the cases with surgical indication; 4. The importance of the IT parameter in the model for financial evaluation of the Integrated Responsibility Centres (IRC). |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004-06-30 |
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info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/1741 |
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https://revista.spmi.pt/index.php/rpmi/article/view/1741 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/1741 https://revista.spmi.pt/index.php/rpmi/article/view/1741/1204 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
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Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Internal Medicine; Vol. 11 No. 2 (2004): Abril/ Junho; 62-69 Medicina Interna; Vol. 11 N.º 2 (2004): Abril/ Junho; 62-69 2183-9980 0872-671X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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