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[Use of the Appropriateness Evaluation Protocol in inpatient ENT practice]
A Neumann1, H J Schultz-Coulon
1Klinik für-Hal -, Nasen, Ohrenheilkunde, Kopf-und Halschirurgie, Plastische Operationen, Phoniatrie und Pädaudiologie, Lukaskrankenhaus, Städtische Kliniken Neuss. a.neumann@online-club.de
Background And Objective:
Determination of inappropriate hospital use is of increasing importance due to limited resources in health care. The Appropriateness Evaluation Protocol (AEP) serves as an instrument to identify this inappropriate hospital use. It was designed in the USA in 1981 for use in Internal Medicine and General Surgery and consists of criteria items to assess the appropriateness of hospital admissions and days of care.
Patients/Methods:
The present study aims to examine the practicability of the AEP in Otorhinolaryngology. The charts of all patients hospitalized in the ENT Department at that particular day were surveyed on 4 consecutive Wednesdays. Three reviewers each reviewed 196 charts.
Results:
The overall level of inappropriate use was 41.5%. Presuming that the day preoperative to elective surgery was appropriate, the level was 23.1%.
Conclusions:
The critical comparison between this result and the actual reasons for hospital admissions and days of care showed, that the present German version of the AEP is less suitable for use in Otorhinolaryngology. Based on the experiences with the AEP an AEP adjusted to Otorhinolaryngology (AEP-ENT) is proposed.