Variability in Rheumatology Day Care Hospitals in Spain: VALORA Study

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• 作者：Mar&iacute ; a Victoria Herná ; ndez Miguel^a ; Mar&iacute ; a Auxiliadora Mart&iacute ; n Mart&iacute ; nez^b ; Hé ; ctor Corominas^c ; Carlos Sanchez-Piedra^b ; Raimon Sanmart&iacute ; ^a ; ^c ; Carmen Fernandez Martinez^b ; Rosario Garc&iacute ; a-Vicuñ ; a^d ; ^{vicuna111@gmail.com} ; on behalf of the project Scientific Committee VALORA
• 关键词：Day care hospital ; Clinical practice variability ; Standard of care ; Rheumatology
• 刊名：Reumatología Clínica (English Edition)
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：13
• 期：1
• 页码：10-16
• 全文大小：352 K
• 卷排序：13

文摘

To describe the variability of the day care hospital units (DCHUs) of Rheumatology in Spain, in terms of structural resources and operating processes.Material and methodsMulticenter descriptive study with data from a self-completed questionnaire of DCHUs self-assessment based on DCHUs quality standards of the Spanish Society of Rheumatology. Structural resources and operating processes were analyzed and stratified by hospital complexity (regional, general, major and complex). Variability was determined using the coefficient of variation (CV) of the variable with clinical relevance that presented statistically significant differences when was compared by centers.ResultsA total of 89 hospitals (16 autonomous regions and Melilla) were included in the analysis. 11.2% of hospitals are regional, 22.5% general, 27% major and 39.3% complex. A total of 92% of DCHUs were polyvalent. The number of treatments applied, the coordination between DCHUs and hospital pharmacy and the post graduate training process were the variables that showed statistically significant differences depending on the complexity of hospital. The highest rate of rheumatologic treatments was found in complex hospitals (2.97 per 1000 population), and the lowest in general hospitals (2.01 per 1000 population). The CV was 0.88 in major hospitals; 0.86 in regional; 0.76 in general, and 0.72 in the complex.ConclusionsThere was variability in the number of treatments delivered in DCHUs, being greater in major hospitals and then in regional centers. Nonetheless, the variability in terms of structure and function does not seem due to differences in center complexity.