| Abstract | Uvod: U radu je opisana problematika sa kojom se susreće Služba za interne bolesti, a odnosi se na karakteristike pacijenata koji su smješteni u domove i udomiteljske obitelji, a koji dolaze u Hitnu internu ambulantu.
Cilj istraživanja: Istražiti kolika je zastupljenost bolesnika koji zahtijevaju medicinsku skrb, smješteni su u domovima i udomiteljskim obiteljima, i dolaze u hitnu internu ambulantu sa dijagnozama pneumonije, dehidracije, sepsa ili urosepse, te u kolikoj mjeri hospitalizacija takvih bolesnika utječe na ostvarivanje indikatora kvalitete i uspješnosti od strane HZZO-a.
Ispitanici i metode: Ispitanici su svi bolesnici koji su došli u Hitnu internu ordinaciju i hospitalizirani s dijagnozom pneumonije, dehidracije, sepsa, smješteni u starački dom ili udomiteljsku obitelj. Podatci su prikupljeni retrogradno iz medicinske dokumentacije.
Rezultati: Sudjelovalo je 100 ispitanika. Ispitanicima je dijagnosticirana sepsa-urosepsa u 31 % slučajeva, 23 % ih je dehidrirano,a 18% imalo je pneumoniju. Promatrajući vrstu smještaja vidljivo je da je 60 % smješteno u starački dom i to 72 % u privatni. Tijekom hospitalizacije 23 % ispitanika primalo je antibiotik sa rezervne liste lijekova, a 4 % ispitanika ima dodijeljenu šifru Z 51.5 pri prijemu. Obradom dobivenih podataka možemo zaključiti da je vrijednost propisanog medijana nadmašena te bolnica zbog toga nije ostvarila dodatna financijska sredstva.
Zaključak: Analizom dobivenih podataka uvidjelo se da su ispitanici smješteni u privatne staračke domove, hospitaliziraju se zbog sepse i dehidracije, i više od polovine se rehospitalizira ponovno. Vrlo malo ih se kod prijema detektira kao palijativne pacijente, znatan broj ih je tijekom hospitalizacije primao antibiotik sa rezervne liste dok je vrlo visok postotak smrti tijekom hospitalizacije. Uzimajući sve te podatke u obzir nije postignut propisan nacionalni medijan. |
| Abstract (english) | Introduction : In this paper doubtfulness with that Department of Internal Diseases faces, regarding characteristics of patients situated in old folks’ homes and settled down, upon their visit in Urgent internal clinics, is discussed.
Goal of investigation : To investigate how great is a deal of patients seeking medical care, who are settled in old folks’ homes and found a home in families, visiting urgent internal clinics for outpatients with diagnoses of pneumonia, dehydration, sepsis, urological sepsis, and to explore to what degree hospitalization of these patients influences on quality indicators and efficiency from aspect of Croatian Health Insuarance Agency (HZZO).
Methods and Examinees : The examinees were all the patients who visited Urgent internal clinics for outpatients, and were hospitalized because of pneumonia, dehydration, sepsis,that were lodged in old folks’ home or settled in families. The data were collected retractively from medical documentation.
Results : One hundred examinees participated in the investigation. In 31 % of cases at examinees urosepsis and sepsis was diagnosed, 23 % were dehydrated, 18 % had pneumonia. According to kind of accomodation, it is obvious that 60 % were placed in old folks’ home, 72 % of them in private ones. During hospitalization 21 % of examinees received antibiotics from spare list of medication, and 4 % of them had code Z 51.5 assigned at admission. Elaborating given data it was concluded that a value of prescribed media was exceeded, so hospital did not realized additional financial benefit.
Conclusion : Analyzing given data it can be seen that examinees settled in private old folks’ homes were hospitalized because of sepsis and dehydration, and more than half of them was re-hospitalized. Very little of them were detected as palliative patients at admission, a great deal of them during hospitalization received antibiotics from a spare list, with a high percentage of lethal outcomes in time of hospitalization. Taking all these data into consideration, the proper national median was not achieved. |
