Appropriateness of short-stay admissions for procedures in six Veterans Affairs hospitals

Admissions records were reviewed for six acute care Veterans Affairs Medical Centers (VAMC's) in New England to determine appropriateness of short-stay admissions (two days or less) in fiscal years 1986 and 1987 for certain medical and surgical procedures. Results indicated that such admissions accounted for 18,588 (22%) of a total of 84,266 admissions for the six hospitals; of these admissions, 4,362 were for procedures commonly performed on an outpatient basis. Criteria developed by a peer review board of physicians was applied to a sample of 728 (16.7%) of the 4,362 short-stay admissions for these procedures; 190 (26.1%) admissions from this sample were found to be inappropriate. Inappropriateness rates (9.1% to 46.1%), as well as the number and type of procedures, varied among the six VAMCs. Some VAMCs may be able to improve efficiency by performing more procedures on an outpatient basis.