[Program of Medical Information System and diseases of the respiratory tract (CMD, No.4). Study of 1,020 hospital stays out of the total of 18,253 hospitalizations at the Centre Hospitalier de Saint-Gaudens in the framework of the National Study of Costs]

Abstract

Objective: To analyse hospital activity, the characteristics and course of patients having been classified, by the programme of medical information system (French PMSI) in the major diagnostic category of respiratory disorders (CMD n(o) 4).

Study: Using the files created by Saint-Gaudens Hospital (145 acute beds, 7000 annual admissions) for three years within the context of the national study of the cost of medical activity. A descriptive statistical analysis then an explanation of the variations of consumptions by stay and by patient.

Results: In CMD n(o) 4 there were 26 homogeneous groups of patients (GHM) representing 1020 hospital admissions (out of a total of 18,253) of whom 76 were admitted as an emergency, 63 were in the thoracic medicine group and 27 had a spell in intensive care, 73% were discharged home and 9.8% died. CMD n(o) 4 represented 9% of the hospitals synthetic activity index (ISA). Of these 822 patients had a mean age of 70, 60% of them had chronic disease and 20% were living alone. The variations of cost had been explained by GHM (P < 0.001), test of variants [ANOVA]) as well as by complementary indicators (performance status WHO) and a simplified index of severity. Men, elderly subjects and those with chronic disease consumed more. Hospital activity determined from CMD n(o) 4 has been compared to an extraction of stays based on pure diagnostic medicine (thoracic medicine) of the principal disorder: important differences were apparent, explained in large part by the method of admission, by the PMSI, respiratory tumours and ambulatory care.

Conclusion: An analysis of activity in thoracic medicine has been able to give an over view of the hospital with the reserves linked to the system which were essentially economic and should be able to be compensated by later improvements seeking to give a more medical aspect to the description of hospital stays.