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Which hospital admissions are appropriate?

J O'Donnell1, J Pilla, L Van Gemert

  • 1Royal Adelaide Hospital, South Australia.

Australian Health Review : a Publication of the Australian Hospital Association
|December 10, 1989
PubMed
Summary

The Appropriateness Evaluation Protocol (AEP) audit tool found 6% of hospital admissions inappropriate. These cases could have been managed at lower care levels, saving costs.

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Area of Science:

  • Health Services Research
  • Hospital Administration
  • Quality Improvement

Background:

  • The Appropriateness Evaluation Protocol (AEP) is a widely used criterion audit tool in the USA.
  • Assessing the appropriateness of hospital admissions is crucial for efficient healthcare resource allocation.
  • The utility of the AEP in non-US healthcare settings requires evaluation.

Purpose of the Study:

  • To evaluate the utility of the Appropriateness Evaluation Protocol (AEP) in an Australian teaching hospital.
  • To identify potential modifications to the AEP criteria for improved audit efficiency in the Australian context.
  • To quantify the rate of inappropriate hospital admissions and their potential cost implications.

Main Methods:

  • The study utilized the Appropriateness Evaluation Protocol (AEP) criteria.
  • A sample of hospital admissions was audited against the AEP criteria.
  • Data analysis focused on identifying inappropriate admissions and estimating associated costs.

Main Results:

  • Six percent of audited hospital admissions were deemed inappropriate based on AEP criteria.
  • Inappropriate admissions represented cases potentially manageable in alternative, lower-level care facilities or on an outpatient/day-patient basis.
  • The estimated additional cost of these inappropriate admissions to an acute hospital was $A1750 per case.

Conclusions:

  • The AEP is a potentially useful tool for assessing hospital admission appropriateness in Australia.
  • Minor modifications to AEP criteria may enhance audit efficiency in Australian teaching hospitals.
  • Inappropriate admissions represent a significant area for potential cost savings and improved resource utilization in acute care settings.

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