Professional paper
Retrospective Analysis of Use and Distribution of Resources in Otolaryngology Wards in Romanian Hospitals Between 2003 and 2008 to Improve Provision and Financial Performance of Healthcare Services
Marian Stamate
orcid.org/0000-0003-1995-3816
; Coltea Clinical Hospital, Bucharest, Romania
Nona Delia Chiriac
; National School of Public Health, Management and Continuous Medical Education, Bucharest, Romania
Abstract
Aim To analyze use and distribution of resources by otolaryngology
(ENT) hospital wards in Romania between 2003
and 2008, in order to plan the improvement of patient access
to health care services and health care services’ financial
performance.
Methods Clinical electronic records were searched for all
patients discharged from all public hospitals funded on a
per-case basis by the government between January 2003
and September 2008. Adult and pediatric ENT wards, as
well as ENT wards from different counties, were compared.
Results The number of ENT hospital beds and the number
of specialists decreased from 2003 to 2004, the number
of specialists declined, and specialists were distributed unevenly
among the hospitals and counties. The total number
of ENT wards was over 100 for almost the entire study period,
but there were only about 15 pediatric ENT wards in all 42
counties. ENT wards recorded more cases and hospitalization
days than oral-maxillofacial surgery and neurosurgery
wards, but fewer cases than general surgery or obstetrics
wards. ENT wards had the lowest mortality rates. Until the
second half of 2007, adult ENT wards had a lower surgical index,
higher complexity of cases, and longer average length
of stay than pediatric ENT wards (P < 0.001, t-test). After 2007,
pediatric ENT wards treated more complex cases (P = 0.004, t
-test) that were less surgical in nature; this result was due to
the shift from the Health Care Finance Administration classification
diagnostic-related group (DRG) system to the Australian
Refined DGR system, as well as to improper use of
codes. ENT wards in different counties differed in the number
of cases, average length of stay, and case mix index.
Conclusion Statistics and case mix clinical data may be a
good starting point for informing hospital management to
assess ENT service coverage, but they should be supplemented
with data on hospitalization costs.
Keywords
Otolaryngology; hospital services; medical practice variations; health care management
Hrčak ID:
58471
URI
Publication date:
15.6.2010.
Visits: 1.289 *