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Factors affecting inappropriate hospital stay
1Department of Clinical Epidemiology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Quality Assurance in Health Care : the Official Journal of the International Society for Quality Assurance in Health Care
|January 1, 1991
Summary
A significant portion of hospital stay days are unjustified, primarily due to diagnostic evaluations and non-emergency treatments. Key factors influencing these unnecessary days include patient age, ethnicity, and ward.
Area of Science:
- Health Services Research
- Hospital Management
- Quality Improvement
Background:
- Hospital utilization is a critical factor in healthcare costs.
- Identifying unjustified hospital stays is essential for efficient resource allocation.
Purpose of the Study:
- To assess the extent and reasons for unjustified hospital stay days across different medical specialties.
- To identify key factors contributing to prolonged hospitalizations.
Main Methods:
- An assessment method utilizing explicit criteria was employed.
- Data were collected from medical, surgical, and pediatric wards of a large teaching hospital.
Main Results:
- Fifty-four percent of medical, 40% of surgical, and 26% of pediatric hospital stay days were deemed unjustified.
- Unjustified days were mainly due to inpatient diagnostic evaluations, non-emergency treatments, and follow-ups.
- Patient age, ethnicity, ward of admission, and diagnostic category were major contributing factors.
Conclusions:
- A substantial number of hospital days are potentially avoidable.
- Findings support the development of hospital utilization management programs for cost containment.
- Targeted interventions addressing patient demographics and care pathways can optimize hospital resource use.