APPROPRIATENESS OF HOSPITAL ADMISSIONS AN D STAYS AMONG PATIENTS WITHUNCOMPLICATED INGUINAL-HERNIA

BACKGROUND: Inguinal hernia uncomplicated in patients aged over 17 yea rs, diagnosis-related group (DRG) 162, generates a substancial number of hospital stays due its high frequency in our country. These stays m ay not be necessary, and present an important temporal and geographica l variability. MATERIAL AND METHODS: We have analyzed a total of 612 d ays of stay belonging to the 124 admissions codified as DRG 162 during the first quarter of 1993 and 1994, using the ''Appropriateness Evalu ation Protocol''. RESULTS: The overall mean stay of the DRG 162 was 5. 0 days (2.3 days of inadequate stay and 2.7 days of clinically necessa ry stay). The mean stay in 1993, 5.6 days, was higher than the mean st ay in 1994, 4.1 days (p = 0.006). The percentage of inappropriate admi ssion was higher in 1993 than in 1994 (33.8% versus 18.9%; p = 0.06). Similarly, the percentage of inappropriate stay was higher in 1993 tha n in 1994 (46.9% versus 41.9%; p = 0.06). The more frequent reasons of inappropriate admission was premature admission (88.2%) and for the s tay was delay in the discharge medical order (33.3%). CONCLUSIONS: The mean stay of DRG 162, as well as the percentage of inadequate stay an d admission, has decreased from 1993 to 1994 in our hospital. Accordin g to the observed trend, the mean stay is approaching the adequate mea n stay for this DRG.