Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden

Soltani, Siamak; Kasnavieh, Mohamad Hoseini; Shaker, Hosein; Abbasian, Ahmad; Amanollahi, Alireza; Tahmasebi, Ali

doi:10.5812/semj.87870

Cited by 6 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, these results have measurement and comparability limitations since economic estimates have traditionally been made on the basis of the individual study of the appropriateness of each day of hospital stay, and our estimation does not consider the specific procedures and treatments that the patient received during his hospitalization. 33,41 Also, some cost could be overestimated, such as those related to patients in the hospital waiting surgical procedures, who may not consume many resources.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inappropriate Hospital Admission According to Patient Intrinsic Risk Factors: an Epidemiological Approach

Jose-Saras

Vicente-Guijarro

Sousa³

et al. 2023

J GEN INTERN MED

View full text Add to dashboard Cite

Background Inappropriate hospital admissions compromise the efficiency of the health care system. This work analyzes, for the first time, the prevalence of inappropriate admission and its association with clinical and epidemiological patient characteristics. Objectives To estimate the prevalence, associated risk factors, and economic impact of inappropriate hospital admissions. Design and Participants This was a cross-sectional observational study of all hospitalized patients in a high complexity hospital of over 901 beds capacity in Spain. The prevalence of inappropriate admission and its causes, the association of inappropriateness with patients’ intrinsic risk factors (IRFs), and associated financial costs were analyzed with the Appropriateness Evaluation Protocol in a multivariate model. Main Measures and Key Results A total of 593 patients were analyzed, and a prevalence of inappropriate admissions of 11.9% (95% CI: 9.5 to 14.9) was found. The highest number of IRFs for developing health care-related complications was associated with inappropriateness, which was more common among patients with 1 IRF (OR [95% CI]: 9.68 [3.6 to 26.2.] versus absence of IRFs) and among those with surgical admissions (OR [95% CI]: 1.89 [1.1 to 3.3] versus medical admissions). The prognosis of terminal disease reduced the risk (OR [95% CI]: 0.28 [0.1 to 0.9] versus a prognosis of full recovery based on baseline condition). Inappropriate admissions were responsible for 559 days of avoidable hospitalization, equivalent to €17,604.6 daily and €139,076.4 in total, mostly attributable to inappropriate emergency admissions (€96,805.3). Conclusions The prevalence of inappropriate admissions is similar to the incidence found in previous studies and is a useful indicator in monitoring this kind of overuse. Patients with a moderate number of comorbidities were subject to a higher level of inappropriateness. Inappropriate admission had a substantial and avoidable financial impact.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This new focus for understanding the causes underlying this type of inappropriateness would be able to drive strategies for improving and optimizing resources. 6,41…”

Section: Discussionmentioning

confidence: 99%

Inappropriate Hospital Admission According to Patient Intrinsic Risk Factors: an Epidemiological Approach

Jose-Saras

Vicente-Guijarro

Sousa³

et al. 2023

J GEN INTERN MED

View full text Add to dashboard Cite

show abstract

“…Reasons for providing unnecessary services in the ED include almost similar factors such as distance to the hospital, delay in treatment, use of personal transport, and referral from other hospitals. [26,28,31] Similarly, l onger stays in the waiting room, longer distances, and the interval between the onset of symptoms and ED admission have been associated with the ED's inappropriate services. [10] Based on the results, the interval between the onset of symptoms and admission to the ED had a significant effect on inappropriate admission.…”

Section: Discussionmentioning

confidence: 99%

The Ratio and Predictor Factors of Inappropriate and Unnecessary Use of Emergency Department Services

Kasnavieh

Mahmoudinejad

Veisy

et al. 2023

APJHM

View full text Add to dashboard Cite

Introduction: Provision of unnecessary medical services is one of the problems that have driven up health care budgets. The condition of Emergency department and sometimes patients 'unreasonable expectations may lead to ED staff burnout and increase the provision of unnecessary services. Methods: In this study, the Hospital Urgencies Appropriateness Protocol (HUAP) was used to assess the appropriateness of services provided in the ED. The sample size of this study consisted of 445 patients who were selected among the patients admitted in Rasoul Akram and Firouzgar hospitals by stratified sampling. Chi-square and logistic regression tests were used to analyze the data. Results: The rate of inappropriate admission in the ED of the studied hospitals was measured at about 13%. Patients admitted to the Firouzgar ED showed a higher probability to inappropriate admission. Among considered factors, gender and Interval between the onset of symptoms and ED admission are affecting factor in inappropriate admission. Conclusion: The rate of in appropriate admission is somehow high in this study. Gender and Interval between the onset of symptoms and ED admission can be considered as predictors of the provision of unnecessary services. So it is significant to provide operational and evidence-based solutions regarding the issues related to the provision of unnecessary services in the ED.

show abstract

“…However, it should be considered that patients who stay longer than necessary or shorter than is actually needed have an impact on the price and standard of care delivered [21]. Although patients who stayed for a prolonged time had poor care outcomes [22,23], they faced financial burdens [24,25], made it difficult for the hospital to run at a high level of efficiency [26,27], were at higher risk of developing complications [28,29], and had increased mortality [11]. Generally, prolonged hospital stays are not beneficial for either patients or hospitals [6,30].…”

Section: Introductionmentioning

confidence: 99%

Length of hospital stay and associated factors among adult surgical patients admitted to a surgical ward in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia

Dadi,

Habte,

Mulu

et al. 2023

Preprint

View full text Add to dashboard Cite

IntroductionHospitals across the country are experiencing a rise in the length of hospital stays, ranging from 2% to 14%. As a result, patients who remain hospitalized for a prolonged period are three times more likely to suffer in-hospital deaths. Therefore, identifying contributing factors for prolonged hospital stays enhances the ability to improve services and the quality of patient care. However, there is limited documented evidence in Ethiopia as well as in the study area about factors associated with prolonged hospital stays among surgical inpatients.ObjectiveThis study aimed to assess the length of hospital stay and associated factors among adult surgical patients admitted to a surgical ward in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia, 2023.MethodsAn institutional-based cross-sectional study was conducted among 452 adult surgical patients from April 17 to May 22, 2023. Data were collected based on a pretested, structured interviewer-administered questionnaire, patient chart review, and direct measurement. Study participants were selected using a systematic random sampling technique. The collected data were cleaned, entered into EpiData 4.6.0 and exported to STATA version 14 for analysis. Binary logistic regression analysis was used. Variables with a p value < 0.05 in the multivariable logistic regression analysis were considered statistically significant.ResultsIn the current study, the prevalence of prolonged hospital stay was 26.5% (95% CI: 22.7–30.8). Patients referred from another public health institution (AOR = 2.46; 95% CI: 1.09, 5.57), hospital-acquired pneumonia (AOR = 3.18; 95% CI: 1.28, 7.89), duration of surgery ≥110 minutes (AOR = 2.48; 95% CI: 1.25, 4.91), and preoperative anemia (AOR = 3.37; 95% CI: 1.88, 6.04) were factors associated with prolonged hospital stays.ConclusionThis study found a significant proportion of prolonged hospital stays. Source of referral, preoperative anemia, duration of surgery, and hospital-acquired pneumonia were factors associated with a prolonged hospital stay. Strengthening the established information system among hospitals when referring patients and early screening and treating anemia upon admission to hospitals can reduce the length of stays.

show abstract

Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden

Cited by 6 publications

References 27 publications

Inappropriate Hospital Admission According to Patient Intrinsic Risk Factors: an Epidemiological Approach

Inappropriate Hospital Admission According to Patient Intrinsic Risk Factors: an Epidemiological Approach

The Ratio and Predictor Factors of Inappropriate and Unnecessary Use of Emergency Department Services

Length of hospital stay and associated factors among adult surgical patients admitted to a surgical ward in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia

Contact Info

Product

Resources

About