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[Premature and avoidable mortality in the San Carlos University Hospital (SCUH)]
S de Juan García1, C Fernández Pérez
1Servicio de Medicina Preventiva, Hospital Universitario San Carlos.
Insights
Deaths amenable to medical intervention in hospitals (MIPSE) were significantly lower than other causes. While overall MIPSE mortality declined, appendicitis deaths rose, indicating potential health service issues.
Area of Science:
- Medical intervention
- Hospital mortality
- Public health
Background:
- Deaths amenable to medical intervention in hospitals (MIPSE) are critical indicators of healthcare quality.
- Defining and tracking MIPSE is essential for evaluating healthcare system performance.
Purpose of the Study:
- To propose and analyze deaths amenable to medical intervention strictly within the hospital setting (MIPSE).
- To examine mortality trends for MIPSE and non-MIPSE causes in a hospital over a decade.
Main Methods:
- A descriptive longitudinal study analyzing yearly mortality data from 1980-1990 at HUSC.
- Categorization of deaths into MIPSE and non-MIPSE causes.
- Statistical analysis of mortality rates and trends.
Main Results:
- MIPSE mortality rate was 0.01 per 100 discharges, significantly lower than non-MIPSE causes (1.61 per 100 discharges).
- Both MIPSE and non-MIPSE mortality series showed a significant declining trend.
- Specific MIPSE causes exhibited varied trends: abdominal hernias decreased, while appendicitis deaths increased.
Conclusions:
- MIPSE mortality rates are significantly lower than non-MIPSE causes, highlighting potential for intervention.
- The rising trend in appendicitis deaths warrants attention as a potential indicator of health service malfunction.
- Establishing a consensus on defining hospital-specific MIPSE causes is necessary for accurate monitoring and improvement.
Abstract:
We propose the inclusion of deaths due to appendicitis, abdominal hernia, cholecystitis and cholelithiasis and complications occurring during pregnancy, delivery and puerperium as causes of death amenable to medical intervention occurring strictly in the hospital setting (MIPSE). We have carried out a descriptive longitudinal study with the yearly mortality series due to MIPSE and no MIPSE caused in the HUSC (1980-1990). The specific mortality rates were of 0.01 per 100 discharges for MIPSE causes and 1.61 per 100 discharges for no MIPSE causes. The difference was statistically significant (p < 0.005). Both series showed a significantly declining tendency. Once the deaths were arranged under their respective headings, we observed a general decreasing tendency that was only statistically significant for abdominal hernias, whereas there was a rising tendency for deaths due to appendicitis. The knowledge of the evolution of hospital MIPSE is a interesting sign of alarm of malfunctioning health services. We believe that a consensus is necessary to elaborate a list of strictly hospitality causes of MIPSE.