Evaluation study on the appropriateness of hospitalization days at a tertiary hospital

Objective To evaluate the appropriateness of hospitalization days at a tertiary hospital in 2014 by means of the Appropriateness Evaluation Protocol (AEP), and to analyze the causes of inappropriate stays. Methods Medical records of inpatients admitted at a tertiary hospital in 2014 were randomly selected. AEP(US version) was used to evaluate the appropriateness of every hospitalization day, while the causes of inappropriate hospitalization day were also analyzed. Results A total of 1 641 days of stay from 148 medical records were reviewed, and 129 days of stay (7.9%) were seen as inappropriate. Two major factors for inappropriate stays were waiting for surgery and waiting for test, roughly 89.1% of the inappropriate hospitalization days. The proportion of inappropriate hospital stays reduced to 4.8% after adjustment of two-day weekend. Inappropriate hospital stays mostly appeared during the second day to the eighth day after admission(93.8%). Logistic analysis results showed that with concomitant symptoms, preoperative waiting days >5 days, high level surgery, non-emergency admission were significantly associated with appropriateness of hospital stays (P<0.05). Conclusions The rate of inappropriate stays will be reduced and the quality of medical services will be improved if comprehensive measures could be carried out according to the causes of inappropriate stays. Key words: Hospitalization days; Appropriateness evaluation protocol; Medical records; Logistic regression