Impacto de los ingresos urgentes innecesarios sobre las estancias hospitalarias en un hospital de Asturias

Díaz, Luis Velasco; Rios, S.; Fuente, David de la; García, Francisco Suárez; Roza, Susana Diego; Alonso, Reyes Fernández

doi:10.1590/s1135-57272005000500004

Cited by 20 publications

(5 citation statements)

References 15 publications

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“…The AEP has had various applications, usually corresponding to inappropriateness studies in specific clinical services. [11][12][13][14][15][16][17] Only a few studies have been conducted on the hospital as a whole. 18,19,21 The various studies use different sampling strategies, which may be related to the study design (retrospective or concurrent) or to the sample unit.…”

Section: Discussion the Appropriateness Evaluation Protocolmentioning

confidence: 99%

“…The AEP has had various applications, usually corresponding to appropriateness studies of specific clinical services such as emergency, medical services, or surgery. [11][12][13][14][15][16][17] Only a few studies have examined the impact of inappropriate admissions and stays on an acute care hospital as a whole. 18,19 The factors traditionally associated with a higher rate of inappropriateness are old age, medical as opposed to surgical services, and prolonged stays.…”

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confidence: 99%

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Associated Factors and Cost of Inappropriate Hospital Admissions and Stays in a Second-Level Hospital

et al. 2009

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The objective of this study was to analyze the variables related to inappropriate admissions and hospital stays and their financial repercussions. This was a descriptive retrospective study in which the Appropriateness Evaluation Protocol (AEP) was applied to a representative sample of 725 hospital admissions and 1350 hospital stays. The cost of inappropriate stays was calculated by cost accounting. The study found that 7.4% of admissions and 24.6% of stays were inappropriate. Inappropriate admissions were significantly related to medical specialties and younger patient age. Inappropriate stays were related to these factors, plus patients being outside their corresponding areas, nonurgent admissions, and low occupancy rate. The cost of the inappropriate admissions and stays was 147 044 euros. Extrapolated to the hospital as a whole this would represent 2125638 euros per year. Steps must be taken to reduce inappropriate admissions and stays to lower health care costs and to reserve hospital resources for patients who genuinely need them.

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Section: Discussion the Appropriateness Evaluation Protocolmentioning

confidence: 99%

mentioning

confidence: 99%

Associated Factors and Cost of Inappropriate Hospital Admissions and Stays in a Second-Level Hospital

et al. 2009

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“…Un aspecto que debe considerarse son las limitaciones inherentes a la utilización del AEP, que son comunes a todos los trabajos que manejan esta herramienta. Por un lado, el AEP no cuestiona si los procedimientos diagnósticos y terapéuticos prestados al paciente hospitalizado están o no indicados, sino que se asume siempre que éstos son adecuados y están correctamente indicados desde el punto de vista clínico, evaluándose exclusivamente el nivel asistencial en el que se prestan, así como el momento y la oportunidad de la prestación, lo que sin duda podría infravalorar la inadecuación 2,14,15 . Asimismo, el hecho de que el cuestionario se elaborara hace 25 años implica que algunos de los supuestos que justifican una estancia podrían haber quedado obsoletos en la actualidad 7 .…”

Section: Discussionunclassified

Adecuación de las estancias hospitalarias en un servicio de neumología

Rodríguez

Morón

Martínez

et al. 2007

Archivos de Bronconeumología

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“…It is more common in surgery departments. Velasco’s [15] study illustrated that patients who were not properly admitted had three times the length of hospital stay compared to those admitted appropriately. Eriksen [16] has measured the proportion of inappropriate admission of internal medicine and the cost, and the findings suggested that not accepting inappropriate admission did not bring the hospital the same percentage of cost reduction.…”

Section: Introductionmentioning

confidence: 99%

Effect of inappropriate admissions on hospitalization performance in county hospitals: a cross-sectional study in rural China

Chang

Chen

Gao

et al. 2019

Cost Eff Resour Alloc

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Background Inappropriate admissions cause excessive utilization of health services compared with outpatient services. However, it is still unclear whether inappropriate admissions cause excessive use of health services compared with appropriate admissions. This study aims to clarify the differences in the hospitalization performances between appropriately admitted inpatients and inappropriately admitted inpatients. Methods A total of 2575 medical records were obtained after cluster sampling in three counties. Admission appropriateness was assessed by appropriateness evaluation protocol (AEP). The propensity score matching (PSM) was computed to match patients in treatment and control group with similar characteristics, and to examine the differences in the utilization of hospitalization services between the two groups. The samples were matched in two major steps in this study. In the first step, total samples were matched to examine the differences in the utilization of hospital services between the two groups using 15 individual covariates. In the second step, PSM was computed to analyze the differences between the two groups in different disease systems using 14 individual covariates. Results For the whole sample, the inappropriate group has lower expenditure of hospitalization (EOH) (difference = − 0.12, p = 0.003) and shorter length of stay (LOS) (difference = − 0.73, p = 0.016) than the appropriate group. For number of clinical inspection (NCI), it has no statistically significant difference (difference = − 0.39, p = 0.082) between the two groups. Among different disease systems, no significant differences were observed between the two groups among EOH, LOS and NCI, except that the EOH was lower in the inappropriate group than that in the appropriate group for surgical disease (difference = − 0.169, p = 0.043). Conclusion Inappropriate admissions have generated excessive health service utilization compared with appropriate admissions, especially for internal diseases. The departments in charge of medical services and hospital managers should pay high attention to the health service utilization of the inappropriately admitted inpatients. Relevant medical policies should be designed or optimized to increase the appropriateness in health care service delivery and precision in clinical pathway management.

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Impacto de los ingresos urgentes innecesarios sobre las estancias hospitalarias en un hospital de Asturias

Cited by 20 publications

References 15 publications

Associated Factors and Cost of Inappropriate Hospital Admissions and Stays in a Second-Level Hospital

Associated Factors and Cost of Inappropriate Hospital Admissions and Stays in a Second-Level Hospital

Adecuación de las estancias hospitalarias en un servicio de neumología

Effect of inappropriate admissions on hospitalization performance in county hospitals: a cross-sectional study in rural China

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