Causales de estancia prolongada de pacientes hospitalizados en las unidades de cuidado intensivo

Abstract

Objective: To determine the causes that most frequently affect the prolongation of the stay of hospitalized patients in Intensive Care Units. Methods: The methodology of this review was based on the search for studies or publications related to the issue of prolongation of stay through generic Internet search engines and consultation of specialized pages. Two criteria were considered to be included in the analysis: 1. That the prolongation of the stay was raised as a fundamental problem of the study. 2. That the results raise the reasons for the prolongation of the stay in the Intensive Care Units. Results: According to what was reviewed in the literature during this research, we found that the causes of prolonged stay include multiple actors in the health system, including health personnel, insurers and providers, and even families and patients. Each of the evaluated causes presents associated factors that contribute to the prolongation of the stay. The main cause of prolonged stay is related to the provider, and as an associated factor in 61.1% of the studies it is due to delays or cancellation of surgical and diagnostic procedures. As a second cause, we find those directly related to the patient, where in 55.5% of the studies reviewed it is found that age is an influencing factor in prolonging the stay and as a third cause we have those related to health personnel, where in 33.3% of the studies, it is associated with lack of relevance to continue hospitalized or a patient with defined discharge, but there are no exit orders. Discussion: When prolonged stays are caused by administrative or sociocultural procedures, they not only represent a problem for the patient and his family, but also for the health provider and the insurer; these stays could be considered inappropriate given that they are related to difficulties in the internal processes of the organizations; On the contrary, when the prolonged hospital stay is generated by the clinical condition of the patient, since they are associated with clinical factors that are inherent to the patient and are not modifiable. Conclusions: The average hospital stay is used as an indicator of efficiency, since it summarizes the use of the bed and the agility of the services provided in hospitals and clinics. prolonged hospital stay generates negative effects on the health system, such as: Increased costs, poor accessibility to hospital services, saturation of emergency services and risks of adverse events.