Navarro-Rubio G, Prat A, Menacho A, Asenjo MA, Salleras L; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1997; 13: 149.
Department of Preventive Medicine and Technical Management, Hospital Clinic i Provincial de Barcelona, Spain.
OBJECTIVES: 1) To quantify the number of inappropriate admissions and days of stay of patients admitted in the surgical unit of a high-tech hospital. 2) To identify the main variables associated to the inappropriateness of admissions and days of stay. 3) To determine the hospital factors determining inappropriate admissions and stays. MATERIAL AND METHODS: The study population was constituted by the patinets discharged during 1992 in the Hospital Clinic i Provincial of Barcelona. A sample of 792 medical records has been collected, representative of those patients, by means of systematic randomized sampling. To appraise the appropriateness of the admission, and of each of the subsequent days of stay, the Appropriateness Evaluation Protocol was applied. Also, a logistic regression model has been elaborated to measure the relative constribution of the different explicative variables of inappropriate hospitalization. RESULTS: The percentage of inappropriate admissions was 34.2% (CI 95%: 30.9% - 37.5%), and most frequent cause of inappropriateness being premature admission (77.1%). The percentage of inappropriateness of days of stay was 27.9% (CI 95%: 26.9% - 28.8%). Organizational problems are the most frequent cause of inappropriate hospital stays (29.1%). A statistically significant relationship has been evidenced by between admission (appropriate/inappropriate) and the variables day of admission, sex, age, type of admission and type of surgical intervention. The odds ratio (OR) of inadequate admission was 21.4 for scheduled admission versus emergency admission. The OR of inappropriate admission was 1.9 for week-end admission versus week days of admission. A statistically significant relationship has also been observed between stay (appropriate/inappropriate) and the variables length of stay, age, sex, day of discharge and type of surgical intervention. CONCLUSIONS: Scheduled admissions taking place in week-ends were the determinant variables of the inappropriateness of the admission in the surgical unit of a high-tech hospital. Also, the inappropriateness of the stays is associated with discharge in week-end days. Premature admission and organizational health care problems of the hospital have been the most frequent causes of inappropriateness of both admissions and days of stay.
Publication Types:
Keywords:
- Hospitalization
- Hospitals
- Hospitals, District
- Hospitals, Special
- Hospitals, Teaching
- Hospitals, University
- Humans
- Odds Ratio
- Patient Discharge
- Physical Examination
- methods
- surgery
- hsrmtgs
Other ID:
UI: 102233335
From Meeting Abstracts