A survey of the necessity of the hospitalization day in an Italian teaching hospital.

G. Apolone, V. Alfieri, A. Braga, V. Caimi, C. Cestari, V. Crespi, P. F. Crosti, F. De Filippi, M. Gelosa, E. Lanzi

Research output: Contribution to journalArticlepeer-review


To assess the extent of inappropriate hospital use in an adult in-patients population we used a modified version of the Appropriateness Evaluation Protocol (A.E.P.) to evaluate retrospectively a cross-section of 273 patient-days in a large teaching hospital in the Greater Milan area. Overall, 41% were judged to represent inappropriate hospital use on the basis of the protocol's criteria. The rate of inappropriate hospital use was significantly associated with admitting specialty, ranging from 12% for surgery, to 20% for cardiology and to about 60% in psychiatric, geriatrics and neurology departments (p less than 0.01). Hospital days of patients with longer stays were more frequently inappropriate: a statistically significant trend of inappropriateness emerged ranging from 30% among patients with total length of stay (LOS) of 1-10 days to 60% among those with LOS greater than 30 days (p less than 0.01). This study confirms that there is a substantial rate of unnecessary use of hospitals but that such inappropriateness does not seem in most cases to be easily modifiable through "simple" organizational changes.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalQuality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care / ISQA
Issue number1
Publication statusPublished - 1991

ASJC Scopus subject areas

  • Medicine(all)


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