Predictors of inappropriate hospital stay: a clinical case study

Panis, Lambert J.G.G.; Gooskens, Marieke; Verheggen, Frank W.S.M.; Pop, P.; Prins, Martin H.

doi:10.1093/intqhc/15.1.57

Cited by 47 publications

(54 citation statements)

References 19 publications

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“…Decreasing the inappropriate admissions can affect the quality of the healthcare services, improve the efficiency of the hospitals and decrease the waiting lists (4,5).…”

Section: Introductionmentioning

confidence: 99%

The Financial Burden of Inappropriate Admissions to Intensive Care Units of Shahid Faghihi and Nemazee Hospitals of Shiraz, Iran, 2014

et al. 2016

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Background: Investigating the conditions and the appropriateness of admission of patients in hospitals is an important issue which can improve the efficiency of health care delivery. Intensive care unit (ICU) is important due to applying expensive financial sources; therefore, its efficient application is of great priority. In this regard, the current study aimed to determine the financial burden of inappropriate admissions in internal intensive care units (IICUs). Methods: It was a cross-sectional study conducted in 2014. A total of 294 patients admitted to IICUs of Shahid Faghihi and Nemazee hospitals of Shiraz, Iran, in 2012 were enrolled into this retrospective study. The study was conducted in two phases, using the guidelines of American critical care association (ACCA) and experts' opinion to investigate the financial burden of inappropriate admissions in IICUs of the above-mentioned hospitals. Results:The results showed no statistically significant relationships among insurance status, insurance type, age, gender and inappropriate admission by applying Chi-square. Among 294 admitted patients under the study, the inappropriate admissions were 11.2% based on the guidelines and 13.6% based on the experts' opinion. The level of agreement of the guidelines and experts' opinion for the inappropriate admissions was 0.076 based on Kappa coefficient. The total financial burden imposed on the insurance agencies and the patients by inappropriate admissions was US$ 47867.78 based on the guidelines and US$ 83241.68 based on the experts' opinion. Conclusions: Inappropriate admissions to ICUs may impose additional costs to the health system and the patients on one hand, and deprives other patients from receiving health services. Therefore, it is crucial to effectively plan for the application of ICU beds.

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“…Decreasing the inappropriate admissions can affect the quality of the healthcare services, improve the efficiency of the hospitals and decrease the waiting lists (4,5).…”

Section: Introductionmentioning

confidence: 99%

The Financial Burden of Inappropriate Admissions to Intensive Care Units of Shahid Faghihi and Nemazee Hospitals of Shiraz, Iran, 2014

et al. 2016

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“…20% of hospital stay was seen to be inappropriate and approximately 45% of these inappropriate hospital stays were mainly due to nonmedical reasons [47]. This therefore proves that the nonmedical reasons such as after care, facilities to recover at home, and various other related reasons need to be investigated and considered in a KM model that is proposed in this paper.…”

Section: Delayed Dischargementioning

confidence: 79%

A Knowledge Management-based Decision-making Model for Planning Patient Discharge in the UK National Health Service

Kamalanathan¹,

Eardley²

2015

IJCA

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The UK National Health Service (NHS) is faced with problems of managing patient discharge and preventing the problems that result from it such as frequent readmissions, delayed discharge, long waiting lists, bed blocking and other such consequences. The problem is exacerbated by the growth in size, complexity and the number of chronic diseases in the NHS. In addition, there is an increase in demand for high quality care, processes and planning. Effective Discharge Planning (DP) requires practitioners to have appropriate, patient personalised and updated knowledge in order to be able to make informed and holistic decisions about a patients' discharge. This research examines the role that Knowledge Management (KM) plays in planning an effective discharge plan. The research examines existing ways in which DP is currently carried out, the stakeholders involved in the DP process and highlights areas requiring further improvement. This research also examines KM models in healthcare and integrates KM with DP in the form of a KM based DP model. The model was developed based on primary research carried out on the stakeholders of DP along with secondary research. The model intends to highlight the nuances that require focusing on, and provides a seamless overview allowing healthcare personnel to impeccably plan the discharge of a patient with the involvement of both patients and their carers. The KM-based DP model is validated by the actors involved in planning the discharge i.e. healthcare personnel. Patients and carers too are involved in DP; however their involvement is focused on their knowledge and experiences influencing the decisions being made. Healthcare personnel such as doctors, nurses and administrators are however actively involved in planning the discharge. General TermsDP -Discharge Planning. KM -Knowledge Management.

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“…[17][18][19][20][23][24][25]34 No menos importante es la diferencia de formación existente entre las distintas especialidades médicas. 35 …”

Section: Por Responsabilidad Del Médicounclassified

“…Entre estas causas se observa la falta de disponibilidad de cuidados sanitarios en el domicilio, 6,35,36 o la imposibilidad de derivar al paciente por inexistencia o falta de disponibilidad de plazas en instituciones alternativas, 20,23,26,30,33 como hogares de ancianos, hospitales para enfermedades crónicas, servicios de atención primaria o servicios de atención domiciliaria. 16,17,23,26,31,33,36,37 Para otros autores, el tiempo de estadía hospitalaria se prolonga de forma inadecuada por las demoras en la autorización por parte de los seguros de salud (en Argentina llamados "obras sociales" o "empresas de medicina prepaga") de ciertas prestaciones como procedimientos diagnósticos, médicos, quirúrgicos o traslados, 31,33 o insumos de procedimientos.…”

Section: Por Responsabilidad Del Sistema De Saludunclassified

Clasificación de las causas que determinan estadía inadecuada útil para la gestión hospitalaria

Elorza

Ripari

Cruciani

et al. 2012

Rev. cub. salud pública

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RESUMENIntroducción: la búsqueda de eficiencia en la gestión hospitalaria motiva el empleo de indicadores de gestión que detecten y evalúen la presencia de estancias hospitalarias inadecuadas. Objetivo: diseñar una clasificación de las causas que determinan una estadía hospitalaria inadecuada adaptada al contexto del sistema de salud argentino. Métodos: se revisaron 25 artículos publicados entre los años 1990 y 2009 en revistas argentinas y de otras nacionalidades, en idioma inglés y español. Para la exploración se incluyeron buscadores genéricos de Internet y las bases de datos bibliográficos: Medline, Cochrane y Lilacs. Las palabras clave empleadas fueron: inappropriateness, inappropriate hospital days, the appropriateness evaluation protocol, factors associated with inappropriate hospitalization days, uso inadecuado de la hospitalización, lenght of stay. Sintesis de los datos: es necesario distinguir entre ingresos y estadías inadecuadas. Las causas de estas últimas, según la clasificación diseñada, pueden deberse a la responsabilidad de: 1. La planificación y gestión hospitalaria. 2. El médico. 3. La familia del paciente. 4. El sistema de salud. Conclusiones: el diseño de esta clasificación es una herramienta útil para la implementación de indicadores de gestión hospitalaria que involucren los días de estadía.Palabras clave: gestión hospitalaria, indicadores, estadía inadecuada. Revista Cubana de Salud Pública 2012; 38(4): 581-590http://scielo.sld.cu 582 ABSTRACT Introduction: the search for the hospital management efficiency encourages the use of management indicators that detect and assess inappropriate lengths of hospital stay. Objective: to design a classification of the causes that determine inappropriate lengths of hospital stay, adjusted for the Argentinean health system setting. Methods: twenty five articles, both in English and Spanish, published from 1990 to 2009 in Argentinean journals and in those of other nations, were reviewed. For this search, the generic Internet's searchers and the main databases such as Medline, Cochrane, Lilacs, and others were consulted. The key words were inappropriateness, inappropriate hospital stays, the appropriateness evaluation protocol, factors associated with inappropriate hospitalization days, uso inadecuado de la hospitalización, length of stay. Results: it is necessary to differentiate incomes from inappropriate lengths of stay. The designed classification included the following causes: 1. Difficulties in hospital planning and management, 2. The physician's responsibility, 3.The responsibility of the patient's family, 4. The responsibility of the health care system. Conclusions: the design of this classification is a useful tool to implement hospital management indicators involving the length of hospital stay.

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Predictors of inappropriate hospital stay: a clinical case study

Cited by 47 publications

References 19 publications

The Financial Burden of Inappropriate Admissions to Intensive Care Units of Shahid Faghihi and Nemazee Hospitals of Shiraz, Iran, 2014

The Financial Burden of Inappropriate Admissions to Intensive Care Units of Shahid Faghihi and Nemazee Hospitals of Shiraz, Iran, 2014

A Knowledge Management-based Decision-making Model for Planning Patient Discharge in the UK National Health Service

Clasificación de las causas que determinan estadía inadecuada útil para la gestión hospitalaria

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