Appropriateness of Pediatric Hospitalization in a General Hospital in Kuwait

Shafik, Magdy H.; Seoudi, Tarek M.M.; Raway, Tarek S.; Harbash, Nowair Z. Al; Ahmad, Meshal M.A.; Mutairi, Hanan F. Al

doi:10.1159/000339084

Cited by 11 publications

(16 citation statements)

References 14 publications

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“…Similar to the results of the present study, the findings of a study by Masoompour et al showed no relationship between insurance and inappropriateness of hospitalization days (23). Several studies have found a direct association between the higher age of the patients and the likelihood of inappropriate hospitalization day (25,29,33,34) while in the present study, this relationship was not approved. The results of a study by Masoompour et al indicated the lack of any statistically significant correlation between the age and inappropriate hospitalization (23).…”

Section: Discussionsupporting

confidence: 86%

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

et al. 2019

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Background: Appropriate allocation of resources is an important issue in the delivery of services that can reduce the health system costs. The inappropriateness of healthcare services is one of the problems that increase the pressure on hospitals and patients. Methods: In this study, the data were collected using the appropriateness evaluation protocol by a medicine specialist at Rasoul Akram Hospital. In total, 248 participants were selected through systematic sampling. To calculate the financial burden simultaneously with the evaluation of inappropriate hospitalization days, the medicine and facility costs along with the cost of bed-day were estimated. Data were analyzed by SPSS software. Results: The type of treatment was surgery in 56.8% of the patients and 43.2% of them were admitted to the hospital for internal medicine. The mean length of stay was 4 ± 6 days. The inappropriate admission rate was estimated at about 6% and the rate of inappropriate hospital stays was 21.5%. The most important factors influencing the inappropriateness of hospitalization were delayed medical consultations, delayed surgery, conservative practitioner, and the follow-up of clinical test results. The sum of the direct financial burden of inappropriate hospitalization for the patients was estimated at around 1060 dollars. Conclusions: The findings of this study indicated that inappropriate hospitalization and admission imposed a huge financial burden on the health system and community. Hospital authorities by considering issues such as delayed medical consultations and delayed surgery can decrease the financial burden of inappropriate hospitalization to a large extent.

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Section: Discussionsupporting

confidence: 86%

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

et al. 2019

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“…12 Latest research has clear evidence that admission in the hospital and stay days are suitable for adults, but very few studies have assessed this use in general pediatric stay environments. [13][14][15] The objective of this study was to determine the prevalence of the patients admitted to the paediatric ward of the hospital in a whole calendar year. Determining the highest rate of disease admission as well as the most patients presenting in each and every month would help in better providence of facilities to the patients and help in improving the outcomes of patients that are admitted.…”

Section: Introductionmentioning

confidence: 99%

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Seema¹,

Khan²,

Jiskani³

et al. 2019

Int J Res Med Sci

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Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.

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“…These found that the rate of inappropriate bed utilisation ranged from 2.0% to 40.7% at the time of admission to hospitals in Israel, 9 Italy, 10,11 Kuwait, 12 Australia, 6 the United Kingdom and the United States, 7 and from 21.4% to 55.5% on subsequent days of care in the United States, 13 Canada, 14 and Italy. 10,11 Thus, the observed percentages of 3.6% PAEP-inappropriate admissions and 14.3% PAEP-inappropriate episodes of ongoing care in this Irish RPU lie towards the lower end of the scale by international standards.…”

Section: Discussionmentioning

confidence: 99%

“…International studies using the original or modified versions of the PAEP found rates of inappropriate bed utilisation of 2.0%–40.7% at the time of admission, 6-12 and 21.4%–55.5% on subsequent days. 10,11,13,14 Greater rates of inappropriate admission were found in association with attributes including male gender, 9 daytime admission, 10 and distant residence.…”

Section: Introductionmentioning

confidence: 99%

Bed Utilisation in an Irish Regional Paediatric Unit – A Cross-Sectional Study Using the Paediatric Appropriateness Evaluation Protocol (PAEP)

ÓhAiseadha

Mannix

Saunders

et al. 2016

Int J Health Policy Manag

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Background: Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU) in University Hospital Limerick (UHL), Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources. Methods: We used a questionnaire based on the paediatric appropriateness evaluation protocol (PAEP), modified and validated for use in the United Kingdom, to prospectively gather data regarding reasons for admission and for ongoing care after 2 days, from case records for all inpatients during 11 days in February (winter) and 7 days in May–June (summer). We conducted bivariate and multivariate analysis to explore associations between failure to meet PAEP criteria and patient attributes including age, gender, admission outside of office hours, arrival by ambulance, and private health insurance. Inpatient bed occupancy and day ward activity were also scrutinised. Results: Mean bed occupancy was 84.1%. In all, 12/355 (3.4%, 95% CI: 1.5%–5.3%) of children failed to meet PAEP admission criteria, and 27/189 (14.3%, 95% CI: 9.3%–19.3%) who were still inpatients after 2 days failed to meet criteria for ongoing care. 35/355 (9.9%, 95% CI: 6.8%–13.0%) of admissions fulfilled only the PAEP criterion for intravenous medications or fluid replacement. A logistic regression model constructed by forward selection identified a significant association between failure to meet PAEP criteria for ongoing care 2 days after admission and admission during office hours (08.00–17.59) (P = .020), and a marginally significant association between this outcome and arrival by ambulance (P = .054). Conclusion: At a mean bed occupancy of 84.1%, an Irish RPU can achieve 96.6% appropriate admissions. Although almost all inpatients met PAEP criteria, improvements could be made regarding emergency access to social services, management of parental anxiety, and optimisation of access to community-based services. Potential ways to provide nasogastric or intravenous fluid therapy on an ambulatory basis, and outpatient antimicrobial therapy (OPAT) should be explored. Elective surgical admissions should adhere to day-of-surgery admissions (DOSA) policy.

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Appropriateness of Pediatric Hospitalization in a General Hospital in Kuwait

Cited by 11 publications

References 14 publications

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

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

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Bed Utilisation in an Irish Regional Paediatric Unit – A Cross-Sectional Study Using the Paediatric Appropriateness Evaluation Protocol (PAEP)

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