Lege Artis Medicinae

[Application of the "homogeneous disease groups" patient classification system in hospital care analysis]

BOJÁN Ferenc1, BELICZA Éva1

APRIL 28, 1993

Lege Artis Medicinae - 1993;3(04)

[In our previous communication, we described the principles and basic concepts of a patient classification system called "homogeneous disease clusters (HBCs)", which allows a multifaceted analysis of hospital activity (1). In this paper, we also report our first methodological experience with the application of the HBCs classification system to the analysis of length of care and hospital performance. Using the HBCs classification system, we analysed the average length of stay and the case mix of inpatients in the clinics of the University of Debrecen Medical School (DOTE) for the period 1 July 1990 to 13 February 1991. Some of the average lengths of stay per clinic and/or per HBCs were longer and some shorter in DOTE clinics than expected from national normative data. Overall in the clinics, the average time between admission and the first intervention was 3.5 days, which varied significantly from clinic to clinic. The clinic and national average lengths of stay for patients with HBCs were usually much longer than the lengths of stay for patients covered under US MEDICARE. We found large, sometimes very large, differences between clinics in the case-mix index, standardised output per bed or standardised output per 100 days of care.]

AFFILIATIONS

  1. Debreceni Orvostudományi Egyetem Társadalomorvostani Intézet

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Lege Artis Medicinae

[Value of laboratory tests in alcohol abuse and alcoholic organ injuries]

NEMESÁNSZKY Elemér, JUHÁSZ Péter

[Alcohol has a toxic effect on the whole body. Alcohol abuse must be considered as one of the risk-factors to be able to challenge a broad spectrum of organ injuries. Chronic alcoholism, however, is a disease. In order to take preventive measures and to discover the early stages of organ damage caused by alcohol abuse, it is important to conduct those laboratory tests which can help to reveal the under Tyingetiology. With regular alcohol intake, the activity of serum enzymes (GGT, SGOT) and the SGOT/SGPT-index become elevated and the mean corpuscular volume of red cells (MCV) will increase. On the basis of their own experiences and supported by data found in the literature, the authors point out that regular alcohol intake cannot be proved by a single test. To enhance the specificity as well as the sensitivity of the laboratory tests, a combination of parameters must be obtained and tests should be repeated after a certain abstention period.]

Lege Artis Medicinae

[Alcohol induced specific cardiomyopathy]

TÁTRAI Tihamér

[Alcoholic cardiomyopathy represents a serious public health problem in Hungary. The author describes the diagnostic criteria and three clinical types: Vitamin B, deficiency, arrhythmic form and congestive alcoholic heart disease. The importance of arrhythmias is emphasized with regard to pathogenesis and clinical features. Non-invasive and invasive diagnostic methods are discussed. The latest therapeutic possibilities are discussed, but emphasis is placed on the importance of prevention.]

Lege Artis Medicinae

[The nomenclature of morphogenetic anomalies]

ÁDÁM Zsolt, PAPP Csaba, TÓTH-PÁL Ernő, PAPP Zoltán

[In spite of the unifying intentions on the nomenclature of congenital anomalies the problem is still considered to be unsolved internationally. Contradictions among each classifications are mainly based on the different viewpoints of practice and scientific researchers. The authors present here a proposition of nomenclature that fits the recommendations of the major international scientific committees but, as a synthesis, they are trying to give a role to etiopathogenesis as well as clinical presentation of congenital abnormalities in their classification. They intended to make this classification to give a proper nomenclature to everyday practice and scientific research work, too.]

Lege Artis Medicinae

[Position of the College of Respiratory Medicine on the care and screening of people with chronic pulmonary diseases]

[The Professional College, on the recommendation of the Epidemiology and Care Section of the Society of Lung Physicians, discussed the above topic at its meeting on 5 February 1993. After a lengthy discussion, and after the clash of opposing views, a compromise resolution was reached, summarised in the following points.]

Lege Artis Medicinae

[Pro-urokinase in myocardial infarction trial]

MATOS Lajos

[The patency of the vessel leading to infarction at 60 min was 71.8% in the rscu-PA group and 48% in the streptokinase-treated group (p < 0.001). At 90 min, the same values were 71.2% and 63.9%, respectively (p = 0.15). Between 24 and 36 h, reocclusion of the vessel occurred in 6/121 cases treated with rscu-PA and 5/114 cases treated with streptokinase. At the end of thrombolytic treatment, fibrinogen concentrations decreased to 0.44 g/l for rscu-PA injection and 0.17 g/l for streptokinase administration. The incidence of bleeding complications was significantly lower after rscu-PA treatment than after streptokinase (p<0.01).]

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