Publicação
An evaluation of the appropriateness of admissions to an Internal Medicine Service using an Appropriateness Evaluation Protocol during the year 2004
| Resumo: | Introduction: The Appropriateness Evaluation Protocol (AEP) is an instrument to measure the appropriateness of admissions based on criteria that permit classification of hospital admission as appropriate or inappropriate. It also could be used to quantify and evaluate the causes of inappropriate use of hospital resources. Objective: Evaluate the appropriateness of hospital admissions of patients admitted in a department of Internal Medicine during the year of 2004, using the prospective version of the AEP.Method: Prospective and random study of the patients admitted in an Internal Medicine department during the year of 2004. We analyzed demographic, clinical (readmissions, co-morbidility and mortality) and administration parameters (hospitalization duration and appropriateness of hospital admission using the AEP, including causes of inappropriateness). Results: 72 patients fulfilled the inclusion criteria with an average age of 70.6 years. 42% were readmissions. The average hospital stay was 7.2 days. Mortality rate was 11.3%. 20.8% of the admissions were considered inappropriate because they did not fulfill any AEP criteria. The most common reason for inappropriate admission was to perform diagnostic exams or treatments that could have been done on an outpatient basis (53.3%).The most common criteria of appropriateness was the need for intravenous therapy (87%), followed by the need for assisted ventilation (12.3%). Conclusions: The AEP allows us to evaluate the appropriateness of hospital admissions in a Health Unit, enabling better utilization of resources. A 20,8% rate of inappropriate admissions was recorded, similar to that found in other studies. The creation of a structure that improves the study of outpatient utilization could decrease inappropriateness of inpatient admissions. |
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| Autores principais: | Vieira, Nuno Bernardino |
| Outros Autores: | Rodriguez-Vera, Javier; Grade, Maria José; Arez, Luísa; Tomé, Rui; Santos, Carlos |
| Assunto: | Appropriateness Evaluation Protocol Admissão adequada Admissão inadequada Appropriateness evaluation protocol appropriated admission inappropriate admission |
| Ano: | 2006 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Instituição associada: | Sociedade Portuguesa de Medicina Interna |
| Idioma: | português |
| Origem: | Revista Portuguesa de Medicina Interna |
| Resumo: | Introduction: The Appropriateness Evaluation Protocol (AEP) is an instrument to measure the appropriateness of admissions based on criteria that permit classification of hospital admission as appropriate or inappropriate. It also could be used to quantify and evaluate the causes of inappropriate use of hospital resources. Objective: Evaluate the appropriateness of hospital admissions of patients admitted in a department of Internal Medicine during the year of 2004, using the prospective version of the AEP.Method: Prospective and random study of the patients admitted in an Internal Medicine department during the year of 2004. We analyzed demographic, clinical (readmissions, co-morbidility and mortality) and administration parameters (hospitalization duration and appropriateness of hospital admission using the AEP, including causes of inappropriateness). Results: 72 patients fulfilled the inclusion criteria with an average age of 70.6 years. 42% were readmissions. The average hospital stay was 7.2 days. Mortality rate was 11.3%. 20.8% of the admissions were considered inappropriate because they did not fulfill any AEP criteria. The most common reason for inappropriate admission was to perform diagnostic exams or treatments that could have been done on an outpatient basis (53.3%).The most common criteria of appropriateness was the need for intravenous therapy (87%), followed by the need for assisted ventilation (12.3%). Conclusions: The AEP allows us to evaluate the appropriateness of hospital admissions in a Health Unit, enabling better utilization of resources. A 20,8% rate of inappropriate admissions was recorded, similar to that found in other studies. The creation of a structure that improves the study of outpatient utilization could decrease inappropriateness of inpatient admissions. |
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