Document Type : Original Article
Authors
Abstract
Background: Continuous assessment of hospital services is an important issue that is necessary for improvement of resource productivity and quality of services. This study aimed to investigate the appropriateness of delivered services in the educational hospitals of Kerman.
Methods: This cross-sectional study was conducted on 300 patients in selected educational hospitals of Kerman to determine the appropriateness of hospital services. Appropriate Evaluation Protocol (AEP), which is the most common tool to assess the appropriate use of hospital services, was used for data collection. Then, the data were analyzed using chi-square test and ANOVA.
Results: The results indicated that the rates of inappropriate admission and hospitalization in the study hospitals were 8% and 14%, respectively. Besides, the results revealed a significant relationship between inappropriate admission and sex (p=0.033), length of hospital stay (p=0.02), and insurance coverage (p=0.011).
Conclusion: Home care education for reducing the length of hospital stay, setting up non-hospital health facilities for reducing referral to upper levels, using AEP in patients’ clinical records, in-service education of medical staff, correction of incomplete processes, and reforms in insurance and payment methods can be used in order to reduce inappropriate admissions and hospitalizations.
Keywords
- Arab M, Zarei A, Rahimi A, Rezaiean F, Akbari F. Analysis of Factors Affecting Length of stay in Public Hospitals in Lorestan Province, Iran. Hakim Research Journal 2010; 12(4): 27- 32 (Persian).
- Yaghoobi far M, Maskani K, Akaberi A, Shahabi F. The Rate of Inappropriate Admissions and Staying of Patients in Hospitals of Sabzevar, Iran. Journal of Sabzevar University of Medical Science 2011; 18(3): 224-232 (Persian).
- Panis G., Lambert Y., Frank W, et al. Predictors of inappropriate hospital stay: a clinical case study. International Journal for Quality in Health Care 2003; 15(1): 57.
- McDonagh, M, Smith D, Goddard M. Measuring appropriate use of acute beds: A systematic review of methods and results. Health Policy 2000; 53(3): 157-184
- Chopard P, Perneger TV, Gaspoz JM, Lovis C, Gousset D, Rouillard C, et al. Predictors of inappropriate hospital days in a department of internal medicine. International Journal of Epidemiology 1998; 27(3):510-521
- Panis LJ, Gooskens M, Verheggen FW, Pop P, Prins MH. Predictors of inappropriate hospital stay: a clinical study. International Journal of Quality Health Care 2003; 15(1): 57-65.
- Kossoovsky M, Chopard P, Boola F. Evaluation of quality improvement intervention to reduce inappropriate hospital use, Intrernational Journal for Quality in Health Care 2002; 14(3): 227-232.
- Bakhtari Agdam F, Gholivahidi R, Mahmoodpoor A, Kawosi Z. Days of admission and stay of patients on the occasion of Appropriate Evaluation Protocol in Emam hospital of tabriz university of medical science. Medical Journal of Tabriz University of Medical Sciences 2007; 30(2): 35-39 (Persian).
- Anton P, Aranaz JM, Calpena R, Compan A, Leutscher E, Ruiz V. Effectiveness of a physician-oriented feedback intervention inappropriate hospital stays. Journal of Epidemiology & Community Health 2007; 61: 128-34.
- Al-Omar B, Al-Ghanim S. Utilization of hospital resources: a survey-based study of Saudi hospitals in Riyadh City. Clinical Governance: An International Journal 2010; 15(2): 134-141.
- Anderson P, Meara J, Brodhurst S. Use of hospital beds: a cohort study of admissions to a provincial reaching hospital. British Medical Journal 1988; 66(53): 2-10.
- Tsang P, Severs M. A study of the appropriateness of acute geriatric admissions and an assessment of the AEP. Journal of Royal college of physicians 1995; 4(1): 4-311.
- Victor C, Nazareth B. The inappropriate use of acute hospital beds in an inner London District Health Authority. Health Trends 1994; 3(2): 94-97.
- Namdaran F, Sherval J. Trends in elderly patients (65 and over) uniting for long stay care in Edinburgh general hospitals. Health Bulletin 1995; 6(3): 8-373.
- Gertman PM, Restuccia JD. The Appropriateness Evaluation Protocol: a technique for assessing unnecessary days of hospital care. Med Care 1981; 19: 71-855.
- Fekari A, Ghiasi A, Ezzati M, Pakdaman M, Khalafi A. The Assessing of Inappropriate Admissions and Hospitalization based on Appropriate Evaluation Protocol in Alinasab hospital in Tabriz- 2009. Journal of Hospital 2010; 9(3, 4): 39-44 (Persian).
- PourReza A, Kavosi Z, Mahmoudi M, Batebi A. Admissions and numbers of days of staying of inpatients on the basis of the Appropriateness Evaluation Protocols in two Tehran University of Medical Sciences hospitals. J School Public Health Inst Public Health Res 2006; 4(3):73-83 (Persian).
- Thollander J, Gertow O, Hansen S, Carlsson B, Hallert C. Assessment of inappropriate emergency admissions: A study 566 consecutive cases. Swedish Medical Journal of Lakartidningen 2004; 101(10):888-92.
- Chopard P, Perneger TV, Gaspoz JM, Lovis C, Gousset D, Rouillard C, et al. Predictors of in appropriate hospital days in a department of internal medicine. International Epidemiological 1998; 27: 513-519.
- Young GJ, Cohen BB. The process and outcome of hospital care for Medicaid versus privately insured hospital patient. Inquiry Journal 1987; 29(4):71-366.
- Neumann A, Schultz-Coulon HJ. Use of appropriateness evaluation protocol in inpatient ENT practice. HNO 2001; 49(1): 12-20.
- Villatla J, Siso A, Cereijo AC, Sequeira E, De Lasierra A. Appropriateness of hospitalization in a short stay unit of a teaching hospital, a controlled study. Med Clin 2002; 122(2): 454-6.
- Hartz J, Priscilla F, Sigmann P. Guse C. The evaluation of screening methods to identify medically unnecessary hospital stay for patient with Pneumonia. International Journal for Quality in Health Care 1996; 8: 3- 11.
- Celik Y, Celik SS, Bulut HD, Khan M, Kisa A. Inappropriate use of hospital beds: a case study of university hospitals in turkey. World Health Serv 2001; 37(1): 6-13.
- Attena F, Agozzino E, Troisi MR, Granito C, Delprete U. Appropriateness of admission and hospitalization days in a specialist hospital. Ann Ig 2001, 13(2): 121-7.
- Appolon G, Fellin G, Tampieri A. Appropriateness of hospital use: an overview of Italian studies. International Journal for Quality in Health Care 1995; 7(3):219-225.
)