Assessing inappropriate hospital stay in Internal Medicine using the Dutch Appropriateness Evaluation Protocol

Panis, Lambert J.G.G.

doi:10.1093/intqhc/14.5.431

Cited by 2 publications

(3 citation statements)

References 18 publications

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“…In addition, other factors have also been known to impact hospital stay in patients admitted to internal medicine wards. One report [7] found that the hospital days needed by hematology and oncology patients could cause a decrease in the LOS, possibly owing to the fact that these patients did not require lengthy hospitalizations, except in the case of a complication. Th us, we excluded all patients who were admitted for chemotherapy in this study.…”

Section: Discussionmentioning

confidence: 99%

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Designing Hospital Key Performance Indicators for Academic Centers: Measuring the Average Length of Stay

Ayoub¹,

Alama²,

AlGhalayini³

et al. 2016

Saudi J Intern Med

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Background: Length of stay is an important performance indicator for hospital management and a key measure of health care efficiency. This paper aims to determine the average length of stay in our center and the factors that influence it. We also investigate whether our hospital's length of stay is a key performance measure that can be used to design quality improvement initiatives. Methods: We performed a retrospective analysis of hospitalizations at the Multi-disciplinary Internal Medicine Department of King Abdulaziz University Hospital, Jeddah between 2010 and 2013. We collected data including demographics, admitting diagnosis, admitting unit, treatments administered, and history of transfer from the Intensive Care Unit. Results: The mean length of stay was 5.9 (6.8) days. Patients admitted through the Emergency Department were more likely to have a longer hospital stay compared with those admitted through Day Care or the Outpatient Department (P < 0.001). Expatriates (P < 0.001), bedridden patients (P = 0.02), and those who received prophylaxis for deep venous thrombosis (P < 0.001) were more likely to have a longer length of stay than the rest of the sample. Furthermore, patients admitted in the morning hours had a significantly shorter length of stay than those admitted in the evening hours (P < 0.001). Conclusion: The length of stay among patients at our department is affected by hospital- or patient-specific factors. Health care can be improved by identifying and monitoring the length of stay in high-risk patients.

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Section: Discussionmentioning

confidence: 99%

“…Patients admitted to internal medicine wards are likely to have co-morbidities which can prolong their hospital stay [7] . However, contrary to previous fi ndings [8,9] , we found that co-morbidities such as DM and IHD did not signifi cantly aff ect LOS in our cases.…”

Section: Discussionmentioning

confidence: 99%

Designing Hospital Key Performance Indicators for Academic Centers: Measuring the Average Length of Stay

Ayoub¹,

Alama²,

AlGhalayini³

et al. 2016

Saudi J Intern Med

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“…A total of 16 criteria were used to evaluate the appropriateness of admission, including severity of illness and service intensity. Based on the AEP criteria of the United States, many countries have explored different AEP criteria that meet their own conditions ( 19 , 20 ). The AEP criteria for county hospitals in China has been developed in 2014 ( Supplementary Table for details) ( 10 ).…”

Section: Methodsmentioning

confidence: 99%

Is there a change in the appropriateness of admission after patients were admitted? Evidence from four county hospitals in rural China

Chang

Gao

et al. 2023

Front. Public Health

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ObjectiveThis study aims to investigate the changes in admission appropriateness after patients were admitted and provide a reference for physicians to make admission decisions and for the supervision of medical service behavior by the medical insurance regulatory department.MethodsMedical records of 4,343 inpatients were obtained based on the largest and most capable public comprehensive hospital in four counties in central and western China for this retrospective study. The binary logistic regression model was employed to examine the determinants of changes in admission appropriateness.ResultsNearly two-in-thirds (65.39%) of the 3,401 inappropriate admissions changed to appropriate at discharge. Age, type of medical insurance, medical service type, severity of the patient upon admission, and disease category were found to be associated with the changes in the appropriateness of admission. Older patients (OR = 3.658, 95% CI [2.462–5.435]; P < 0.001) were more likely to go from “inappropriate” to “appropriate” than younger counterparts. Compared with circulatory diseases, the case evaluated as “appropriate” at discharge was more frequent in the urinary diseases (OR = 1.709, 95% CI [1.019–2.865]; P = 0.042) and genital diseases (OR = 2.998, 95% CI [1.737–5.174]; P < 0.001), whereas the opposite finding was observed for patients with respiratory diseases (OR = 0.347, 95% CI [0.268–0.451]; P < 0.001) and skeletal and muscular diseases (OR = 0.556, 95% CI [0.355–0.873]; P = 0.011).ConclusionsMany disease characteristics gradually emerged after the patient was admitted, thus the appropriateness of admission changed. Physicians and regulators need to take a dynamic view of disease progression and inappropriate admission. Aside from referring to the appropriateness evaluation protocol (AEP), they both should pay attention to individual and disease characteristics to make a comprehensive judgment, and strict control and attention should be paid to the admission of respiratory, skeletal, and muscular diseases.

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Assessing inappropriate hospital stay in Internal Medicine using the Dutch Appropriateness Evaluation Protocol

Cited by 2 publications

References 18 publications

Designing Hospital Key Performance Indicators for Academic Centers: Measuring the Average Length of Stay

Designing Hospital Key Performance Indicators for Academic Centers: Measuring the Average Length of Stay

Is there a change in the appropriateness of admission after patients were admitted? Evidence from four county hospitals in rural China

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