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International Journal for Quality in Health Care 7:261-265 (1995)
© 1995 International Society for Quality in Health Care

Factors Associated with Inappropriate Hospitalization in Medical Wards: a Cross-sectional Study in Two University Hospitals

YAEL PALDI*, AVI PORATH*, LIAT FRIEDMAN{ddagger} and BENJAMIN MOZES{ddagger}

* Clinical Epidemiology Unit, Faculty of Health Services, Ben Gurion University of the Negev Beer Sheva, Israel
{ddagger} Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University Tel Aviv, Israel

A comparative study of the appropriateness of hospitalization was conducted in the medical departments of two university hospitals in Israel. A cross-section of 297 patients on one hospitalization day was analyzed using the Appropriateness Evaluation Protocol (AEP). Data were independently collected by two reviewers (R1 and R2).

The study revealed a significant difference in the percent of inappropriate hospitalization between the two hospitals, i.e. 13.3% (R1) or19.3% (R2) for hospital B, and 24.5% (R1) or 32% (R2) for hospital A. The reviewers were in agreement regarding evaluation (92.6%, Kappa 0.78) of 275 index days. A multivariate analysis of the index days with agreed appropriateness correlated with occupancy and length of stay. Routine monitoring of appropriateness of hospital stay should, therefore, be targeted to medical departments with relatively low occupancy rates and/or prolonged average stay.

Keywords: Appropriateness Evaluation Protocol (AEP), occupancy, inappropriate hospitalization, prolonged stay

B. Mozes, M.D., Gertner Institute, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. Tel: 972-3-5303272; Fax: 972-3-5303277.

Received for publication April 15, 1994. Accepted for publication April 7, 1995.


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