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International Journal for Quality in Health Care 7:187-199 (1995)
© 1995 International Society for Quality in Health Care

A European Project Assessing the Appropriateness of Hospital Utilization: Background, Objectives and Preliminary Results

ALESSANDRO LIBERATI*, GIOVANNI APOLONE*, THIERRY LANG{dagger}, SUSANA LORENZO{ddagger} on behalf of the project Steering Group and the Coordinating Center

* Laboratory of Clinical Epidemiology, Mario Negri Institute Milan, Italy
{dagger} Assistance Publique, H÷pitaux de Paris, H÷pital de la Pitié-Salpétrière, Service D'informatique Medicale Paris, France
{ddagger} Unidad de Evaluacion de la Practica Medica, Escuela Nacional de Sanidad Madrid, Spain

This paper presents the background, objectives and preliminary results of a coordinated European Project involving researchers in seven countries aimed at harmonizing methods to assess inappropriate use of hospital care and qualifying its determinants.

After briefly reviewing the philosophy of the European Union "Concerted Action" program in the context of current attempts at reforming the way health care is financed and delivered in several member states, the paper presents results obtained so far. Besides a method workshop where the approaches and methodologies used were compared, during the first year the following tasks have been undertaken: (a) identification and appraisal of a few dozen empirical studies conducted in various countries; (b) qualitative comparison of the instruments used to assess appropriateness; (c) initial development of a common list of reasons for inappropriate hospital use of potential relevance in European health care systems. While the project has already undoubtedly indicated the great potential of European collaboration in health services research, the large number of unpublished studies traced indicates—among other things—the need to create channels through which results of this type of research can be disseminated.

Keywords: Appropriateness, hospital us, utilization review

A. Liberati, MD, Laboratorio di Epidemiologia Clinica, Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milano, Italy. Tel: 39-2-39014540; Fax: 39-2-33200231.

Received for publication April 6, 1995. Accepted for publication June 8, 1995.


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