Abstract
Background and aim: Hospital computer systems today give fairly prompt information on the complexity of the cases admitted to each department and the work involved. However, there is no official data bank covering all the gastroenterology units in Italy, to provide a summary picture and benchmarks for this activity. Material and Methods: The RING observational study (Ricerca INformatizzata in Gastroenterologia computer-managed research in gastroenterology), using dedicated software, has collected hospital discharge files (HDF) from 63 Italian gastroenterology units throughout the country since 2001. There are now more than 75,000 HDF, giving valuable information for clinical and managerial decisions on the cases admitted. Results: The RING data base has worked with 63 gastroenterology departments, between January 2001 and December 2004, collecting a total of 60,016 HDF for ordinary admissions (OA) (78.5%) and 16,405 day hospital admissions (21.5%) (Table 1). Equal numbers of males and females were admitted, with a mean age of 60.7 ± 18.6 years. Their hospital stay averaged eight days in the fouryear observation period, with no substantial changes from one year to another. OA for DRG 183 (Esophagitis, gastroenteritis and miscellaneous digestive disorders) dropped significantly over the years, from 11.5% in 2001 to 8.0% in 2004 (p<0.0001), and increased in 2004 for cirrhosis and hepatocellular carcinoma (HCC); the frequency of OA for non-varicose upper digestive tract bleeding and acute pancreatitis also rose (Table 2). This pattern was confirmed by the ten top-ranking diagnoses at discharge where post-hepatitis and alcohol-related cirrhosis of the liver, and HCC, were followed by acute pancreatitis, duodenal and gastric ulcers (Table 3). Conclusions: The RING data base shows that over the last few years the gastroenterologist has been increasingly dealing with patients whose diseases were until recently inappropriately treated surgically (DRG 204 and 174). The reduction in DRG 183 cases indicates a decrease in this inappropriateness.
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