The evolution of hospital activity, variations in surgical practice, overall and addressed to vulnerable patients

The whole modern health management aims to shift the healthcare from hospitals to outpatient care. During last decades, EU reduced the number of hospital beds, the length of stay, trying to improve the efficiency of the health system. Is this possible to be done, preserving in the same time the equal coverage with health services, limiting the practice variations? The present study presents the evolution of the main indicators for the volume of hospital and surgical activity; some of differences recorded among regions or patient groups, and identifies features of the surgical practice concerning some vulnerable age groups of patients: children and elderly. The conclusions point out that the hospital activity increased, but varied among districts and age groups. There are some surgical interventions that occur very often in children or consume many hospital days in elderly that might need special analysis in order to evaluate their appropriateness or efficiency.