Appropriateness of hospital use: Report from an Italian study

G. Apolone, G. Fellin, A. Tampieri, E. Bonanoni, P. F. Crosti, E. Lanzi, G. Meregalli, G. Trocino, A. Liberati

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The objective was to assess the extent of inappropriate hospital admission and stay in an adult patient population and identify potential correlates of such inappropriateness. Design: a cross-sectional survey on a sample of 1,082 in-patients using a modified version of the appropriateness evaluation protocol (AEP). Setting: adult acute departments in a 950 bed teaching hospital in the greater Milan area. The patient sample consisted of patients cared for at i of the participating departments on any of 3 index days between October 1989 and June 1990. The results show that overall 27% of the admissions and 40% of the hospital days were inappropriate. The rate of inappropriate admissions was higher for patients admitted during week days and was also significantly associated with the admitting ward and the age of the patient. Inappropriate hospital-day stays were related to the type of ward and to the location during the stay, with those sampled in the later part of their stay having the highest rate of inappropriateness. Most of the hospital clays rated as not appropriate did not require any further stay (75%). Conclusions: a substantial proportion of hospital use was found to be medically unnecessary and, for the most part, due to hospital functioning or the behaviour of the doctors. Some properties of the AEP (high Inter-rater reliability, predictivity of expected associations) were also confirmed. The basic features of this revised version of the AEP make it a good candidate for becoming of great importance in monitoring the effect of the changes the Italian National Health Service is currently undergoing.

Original languageEnglish
Pages (from-to)34-39
Number of pages6
JournalEuropean Journal of Public Health
Volume7
Issue number1
Publication statusPublished - 1997

Fingerprint

Length of Stay
National Health Programs
Teaching Hospitals
Cross-Sectional Studies
Population
clay

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Apolone, G., Fellin, G., Tampieri, A., Bonanoni, E., Crosti, P. F., Lanzi, E., ... Liberati, A. (1997). Appropriateness of hospital use: Report from an Italian study. European Journal of Public Health, 7(1), 34-39.

Appropriateness of hospital use : Report from an Italian study. / Apolone, G.; Fellin, G.; Tampieri, A.; Bonanoni, E.; Crosti, P. F.; Lanzi, E.; Meregalli, G.; Trocino, G.; Liberati, A.

In: European Journal of Public Health, Vol. 7, No. 1, 1997, p. 34-39.

Research output: Contribution to journalArticle

Apolone, G, Fellin, G, Tampieri, A, Bonanoni, E, Crosti, PF, Lanzi, E, Meregalli, G, Trocino, G & Liberati, A 1997, 'Appropriateness of hospital use: Report from an Italian study', European Journal of Public Health, vol. 7, no. 1, pp. 34-39.
Apolone G, Fellin G, Tampieri A, Bonanoni E, Crosti PF, Lanzi E et al. Appropriateness of hospital use: Report from an Italian study. European Journal of Public Health. 1997;7(1):34-39.
Apolone, G. ; Fellin, G. ; Tampieri, A. ; Bonanoni, E. ; Crosti, P. F. ; Lanzi, E. ; Meregalli, G. ; Trocino, G. ; Liberati, A. / Appropriateness of hospital use : Report from an Italian study. In: European Journal of Public Health. 1997 ; Vol. 7, No. 1. pp. 34-39.
@article{e28708022e2a47198970aaf581071d42,
title = "Appropriateness of hospital use: Report from an Italian study",
abstract = "The objective was to assess the extent of inappropriate hospital admission and stay in an adult patient population and identify potential correlates of such inappropriateness. Design: a cross-sectional survey on a sample of 1,082 in-patients using a modified version of the appropriateness evaluation protocol (AEP). Setting: adult acute departments in a 950 bed teaching hospital in the greater Milan area. The patient sample consisted of patients cared for at i of the participating departments on any of 3 index days between October 1989 and June 1990. The results show that overall 27{\%} of the admissions and 40{\%} of the hospital days were inappropriate. The rate of inappropriate admissions was higher for patients admitted during week days and was also significantly associated with the admitting ward and the age of the patient. Inappropriate hospital-day stays were related to the type of ward and to the location during the stay, with those sampled in the later part of their stay having the highest rate of inappropriateness. Most of the hospital clays rated as not appropriate did not require any further stay (75{\%}). Conclusions: a substantial proportion of hospital use was found to be medically unnecessary and, for the most part, due to hospital functioning or the behaviour of the doctors. Some properties of the AEP (high Inter-rater reliability, predictivity of expected associations) were also confirmed. The basic features of this revised version of the AEP make it a good candidate for becoming of great importance in monitoring the effect of the changes the Italian National Health Service is currently undergoing.",
author = "G. Apolone and G. Fellin and A. Tampieri and E. Bonanoni and Crosti, {P. F.} and E. Lanzi and G. Meregalli and G. Trocino and A. Liberati",
year = "1997",
language = "English",
volume = "7",
pages = "34--39",
journal = "European Journal of Public Health",
issn = "1101-1262",
publisher = "NLM (Medline)",
number = "1",

}

TY - JOUR

T1 - Appropriateness of hospital use

T2 - Report from an Italian study

AU - Apolone, G.

AU - Fellin, G.

AU - Tampieri, A.

AU - Bonanoni, E.

AU - Crosti, P. F.

AU - Lanzi, E.

AU - Meregalli, G.

AU - Trocino, G.

AU - Liberati, A.

PY - 1997

Y1 - 1997

N2 - The objective was to assess the extent of inappropriate hospital admission and stay in an adult patient population and identify potential correlates of such inappropriateness. Design: a cross-sectional survey on a sample of 1,082 in-patients using a modified version of the appropriateness evaluation protocol (AEP). Setting: adult acute departments in a 950 bed teaching hospital in the greater Milan area. The patient sample consisted of patients cared for at i of the participating departments on any of 3 index days between October 1989 and June 1990. The results show that overall 27% of the admissions and 40% of the hospital days were inappropriate. The rate of inappropriate admissions was higher for patients admitted during week days and was also significantly associated with the admitting ward and the age of the patient. Inappropriate hospital-day stays were related to the type of ward and to the location during the stay, with those sampled in the later part of their stay having the highest rate of inappropriateness. Most of the hospital clays rated as not appropriate did not require any further stay (75%). Conclusions: a substantial proportion of hospital use was found to be medically unnecessary and, for the most part, due to hospital functioning or the behaviour of the doctors. Some properties of the AEP (high Inter-rater reliability, predictivity of expected associations) were also confirmed. The basic features of this revised version of the AEP make it a good candidate for becoming of great importance in monitoring the effect of the changes the Italian National Health Service is currently undergoing.

AB - The objective was to assess the extent of inappropriate hospital admission and stay in an adult patient population and identify potential correlates of such inappropriateness. Design: a cross-sectional survey on a sample of 1,082 in-patients using a modified version of the appropriateness evaluation protocol (AEP). Setting: adult acute departments in a 950 bed teaching hospital in the greater Milan area. The patient sample consisted of patients cared for at i of the participating departments on any of 3 index days between October 1989 and June 1990. The results show that overall 27% of the admissions and 40% of the hospital days were inappropriate. The rate of inappropriate admissions was higher for patients admitted during week days and was also significantly associated with the admitting ward and the age of the patient. Inappropriate hospital-day stays were related to the type of ward and to the location during the stay, with those sampled in the later part of their stay having the highest rate of inappropriateness. Most of the hospital clays rated as not appropriate did not require any further stay (75%). Conclusions: a substantial proportion of hospital use was found to be medically unnecessary and, for the most part, due to hospital functioning or the behaviour of the doctors. Some properties of the AEP (high Inter-rater reliability, predictivity of expected associations) were also confirmed. The basic features of this revised version of the AEP make it a good candidate for becoming of great importance in monitoring the effect of the changes the Italian National Health Service is currently undergoing.

UR - http://www.scopus.com/inward/record.url?scp=0030994499&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030994499&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0030994499

VL - 7

SP - 34

EP - 39

JO - European Journal of Public Health

JF - European Journal of Public Health

SN - 1101-1262

IS - 1

ER -