Evaluation of the efficiency and efficacy of hospital diagnosis and treatment protocols

Abstract

Introduction. The working protocol is a guidance document that contains a set of instructions on which decisions are made on the clinical management of a disease. It is the standard required to guarantee the quality of the medical practice, it allows the medical act to be evaluated in order to fund it, including in relation to the skills and overspecialization of doctors and is a reference tool in assessing possible malpractice accusations. Aim of the study. Aim of the study. was to compare the efficacy and efficiency indicators from March 2017 with those from March 2018 to assess hospital medical activities after improving the protocols. Materials and methods. The medical activities for which work protocols have been developed were evaluated by two types of indicators: efficacy and efficiency indicators. These indicators were extracted from the hospital's computer system and comparative relationships can be established regarding the number of cases that have developed acute complications, the number of deaths or the related direct average costs. Results. In March 2017 (2016 reporting) and March 2018 (2017 reporting), 149 protocols were evaluated. 94 (63%) of them came from medical departments. For 2016, 20.040 continuous hospitalizations were based on developed protocols, 1332 (6.6%) of them developed an acute complication, 616 (3%) developed 2 acute complications and 532 (2.6%) reported deaths. For the year 2017, 21.140 continuous hospitalizations were based on elaborate protocols, of which 1226 (5.7%) developed an acute complication, 507 (2.3%) developed 2 acute complications and 525 (2.4%) reported deaths. Conclusions. Based on the analysis of the data we can conclude that following the improvement of the diagnostic and treatment protocols, the number of acute complications and the number of deaths decreased even the number of hospitalizations increased from one year to the next one.