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Revista Médica del Uruguay
Print version ISSN 0303-3295On-line version ISSN 1688-0390
Abstract
PIZZAROSSA, Ana Carina; NICASSIO, Lorena; CANEPA, Analía and REBELLA, Martín. Quality of health care for patients with acute pneumonia in a medical clinic of the university hospital between 2010 and 2014. Rev. Méd. Urug. [online]. 2020, vol.36, n.2, pp.12-35. Epub June 01, 2020. ISSN 0303-3295. https://doi.org/10.29193/rmu.36.2.1.
Introduction:
the extent to which clinical practice guidelines in the handling of community acquired acute pneumonia are observed is not known in Uruguay.
Objective:
to assess the degree of compliance with the clinical guidelines in immunocompetent patients hospitalized with a diagnosis of community-acquired pneumonia in a medical clinic of the University Hospital.
Method:
observational, retrospective study. Patronymic and clinical variables, and quality of health care indicators were analysed as per international standards. The degree of compliance with indicators was classified as ideal when compliance was > 90%, intermediate when it was between 60% and 90% and low when it was < 60%. ConsenSur II and IDSA were the reference guidelines used.
Results:
143 patients were included in the study, 6.9 % were female (88/140), with a median age of 57 years old (38-73). The population studied was characterized by Charlson median of 1 (0-3), hospitalization median of 10 (7-14) days and 26.6% (38/143) of patients with acute pneumonia criteria. As to compliance with quality of health care indicators: none of them is ideal, 3 in intermediate level (hemoculture in patients with acute pneumonia, hemoculture prior to antibiotic therapy and administration of antibiotics within the first 8 hours), while 4 variables that assess the use of the appropriate antibiotic according to the guidelines and the prevention of pneumonia evidence a low level of compliance.
Conclusions:
none of the assessed indicators evidenced an ideal level of compliance. Interventions are required to improve quality in health care for patients with pneumonia.
Keywords : Community acquired infections; Pneumonia; Practice guidelines; Quality of health care.