Investigating inappropriate admissions and hospitalizations in Yasuj educational hospitals based on appropriateness evaluation protocol (AEP): A case study in the internal and surgical wards

Hamed Rahimi, Rahim Ostovar, Leila Vali and Parvin Angha

International Journal of Health Planning and Management, 2019, vol. 34, issue 2, 636-643

Abstract: Background Examining the conditions for hospital admission and its appropriateness, and continuous investigation of hospital services are important issues that can improve resource productivity, service quality, and hospital efficacy. So, the present study was conducted to determine the appropriateness of the services provided in Yasuj educational hospitals. Methods This descriptive‐analytical study was carried out on 204 hospitalized patients who were selected through multistage quota sampling in 2016. The appropriateness evaluation protocol (AEP) was used to collect the data. Analytical tests such as paired t‐test, chi‐square test, and Fisher's exact test were used to determine the relationship between appropriate and inappropriate admission and hospitalization and demographic characteristics. The data were analyzed using the SPSS18 statistical software. Results A total of 980 days of stay were evaluated, and according to the AEP, 35 days of hospitalization were considered inappropriate (3.57%). The mean hospitalization duration was 6/16 ± 5/53 days. The results showed that inappropriate admission and hospitalization rates were respectively 0.6% and 13.8%. Conclusion Unnecessary admissions and hospitalizations can be considered as one of the challenges of the health system. Reducing unnecessary hospitalization will increase hospital productivity, reduce the waiting list and hospitalization costs, and also reduce the risk of exposure to hospital infections. In order to prevent inappropriate admissions and unnecessary hospitalizations, special measures can be taken, including the use of clinical guidelines, modification of the discharge process, and modification of the lower levels of the service providing system.

Date: 2019
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