Appropriateness of Hospital Stays in a Pulmonology Department

Rodríguez, Francisco Campos; Morón, Inés de la Cruz; Martínez, Araceli Díaz; Rodríguez, Luis López; Lucena, F. Muñoz; Fernández, Martín Tejedor

doi:10.1016/s1579-2129(07)60100-1

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…Location of patients outside their nursing unit (“outlying”) has been considered by few authors [11]. The condition of outlying patient in our study was significantly associated with a greater inappropriateness of stay.…”

Section: Discussionmentioning

confidence: 59%

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Reduction in inappropriate hospital use based on analysis of the causes

Soria-Aledo

Carrillo-Alcaraz

Flores-Pastor

et al. 2012

BMC Health Serv Res

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BackgroundTo reduce inappropriate admissions and stays with the application of an improvement cycle in patients admitted to a University Hospital. The secondary objective is to analyze the hospital cost saved by reducing inadequacy after the implementation of measures proposed by the group for improvement.MethodsPre- and post-analysis of a sample of clinical histories studied retrospectively, in which the Appropriateness Evaluation Protocol (AEP) was applied to a representative hospital sample of 1350 clinical histories in two phases. In the first phase the AEP was applied retrospectively to 725 admissions and 1350 stays. The factors associated with inappropriateness were analysed together with the causes, and specific measures were implemented in a bid to reduce inappropriateness. In the second phase the AEP was reapplied to a similar group of clinical histories and the results of the two groups were compared. The cost of inappropriate stays was calculated by cost accounting. Setting: General University Hospital with 426 beds serving a population of 320,000 inhabitants in the centre of Murcia, a city in south-eastern Spain.ResultsInappropriate admissions were reduced significantly: 7.4% in the control group and 3.2% in the intervention group. Likewise, inappropriate stays decreased significantly from 24.6% to 10.4%. The cost of inappropriateness in the study sample fell from 147,044 euros to 66,642 euros. The causes of inappropriateness for which corrective measures were adopted were those that showed the most significant decrease.ConclusionsIt is possible to reduce inadequacy by applying measures based on prior analysis of the situation in each hospital.

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Section: Discussionmentioning

confidence: 59%

“…The AEP has had various applications, corresponding usually to inappropriateness studies in specific clinical services [11-17]. Only a few studies have conducted a global inappropriateness study on a hospital as a whole [18,19].…”

Section: Discussionmentioning

confidence: 99%

Reduction in inappropriate hospital use based on analysis of the causes

Soria-Aledo

Carrillo-Alcaraz

Flores-Pastor

et al. 2012

BMC Health Serv Res

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“…The difference in average length of stay before and after ERAS translates into the cost difference, rather than the absolute length of hospital stay. The shortening of the average length of stay essentially reduces the number of ineffective hospitalisation days that are of no value to the patient and of little benefit to the hospital [ 35 , 36 ]. Consequently, the consumption of social resources and the economic payment for patients are reduced.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive economic evaluation of enhanced recovery after surgery in hepatectomy

Dong

Zhang

Jin

2021

Int J Equity Health

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Background Enhanced recovery after surgery (ERAS) is attracting extensive attention and being widely applied to reduce postoperative stress and accelerate recovery. However, the economic benefits of ERAS are less clarified at the social level. We aimed to assess the economic impact of ERAS in hepatectomy from the perspectives of patients, hospitals and society, as well as identify the approach to create the economic benefits of ERAS. Methods By combining the literature and national statistical data, the cost-effectiveness framework was clarified, and parameter values were determined. Cost-effectiveness analysis, cost–benefit analysis and cost-minimisation analysis were used to compare ERAS and conventional treatment from the perspectives of patients, hospitals and society. The capital flow diagram was used to analyse the change between them. Results ERAS significantly reduced the economic burden of disease on patients ($8935.02 vs $10,470.02). The hospital received an incremental benefit in ERAS (the incremental benefit cost ratio value is 1.09), and the total social cost was reduced ($5958.67 vs $6725.80). Capital flow diagram analysis demonstrated that the average daily cost per capita in the ERAS group increased ($669.51 vs $589.98), whereas the benefits depended on the reduction of hospital stay and productivity loss. Conclusion The mechanism by which ERAS works is to reduce the average length of stay, thereby reducing the economic burden and productivity loss on patients and promoting the hospital bed turnover rate. Therefore, ERAS should further focus on accelerating the rehabilitation process, and more economic support (such as subsidies) should be given to hospitals to carry out ERAS.

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“…22,23 Elderly patients had a significant higher rate than younger ones; this could be attributed to their higher clinical and social problems. 14,24 As long as they live, they develop multiple, complex and chronic debilitating diseases requiring prolonged hospital stay. 25…”

Section: Methodsmentioning

confidence: 99%

Inappropriateness of Hospital Admission, Hospital Stay and Bed Utilization at Monufia University Hospitals, Egypt

Sharfeldin

Mahrous

Gabr

et al. 2019

The Egyptian Family Medicine Journal

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Background: Worldwide, inappropriate hospital admission and stay is one of the most important challenges facing all health systems. Objectives: The current study aimed to estimate frequency of inappropriate admission and stay, determine risk factors associated with inappropriateness and study the bed utilization patterns in 2016 at Monufia University Hospitals. Methods: A total number of 350 patients (1637 days) admitted to various departments of Monufia University Hospitals were included in this cross-sectional study. Patients were interviewed, their hospitalization days were assessed by Appropriateness Evaluation Protocol (AEP) and their records were analyzed. Results: Percentages of inappropriate hospital admission and stay were 18.3% and 18.6% respectively. General surgery department had the highest rate of inappropriateness (32.8%). Admission to avoid the waiting time for an outpatient investigation was the most common reason of inappropriate admission (48.4%),while waiting for surgical procedure was the most common reason of inappropriate pre-procedure hospital stay (64.2%) and conservative practice was the most common reason of inappropriate post-procedure hospital stay (58.4%). Overall bed occupancy rate was 76.39% and average hospital stay was 4.12 days. Inappropriate admission was related to rural residency and to patients living >10 km away from the hospital, while inappropriate stay was related to older age >50 y and long hospital stay. Conclusion:The most common reason of inappropriate hospitalization was unorganized hospital schedules of treatment and discharge of patients. Proper monitoring of length of stay (LOS) and bed utilization rates can early detect any hospitalization defect and thus improve hospital efficiency.

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Appropriateness of Hospital Stays in a Pulmonology Department

Cited by 3 publications

References 10 publications

Reduction in inappropriate hospital use based on analysis of the causes

Reduction in inappropriate hospital use based on analysis of the causes

Comprehensive economic evaluation of enhanced recovery after surgery in hepatectomy

Inappropriateness of Hospital Admission, Hospital Stay and Bed Utilization at Monufia University Hospitals, Egypt

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