A multicenter study on the appropriateness of hospitalization in obstetric wards: application of Obstetric...

Area of Science:

• Healthcare Management
• Quality Improvement
• Obstetrics

Background:

• Inappropriate hospital admissions lead to increased healthcare costs and reduced quality of care.
• The Obstetric Appropriateness Evaluation Protocol (OAEP) is a tool to assess the appropriateness of obstetric hospitalizations.

Purpose of the Study:

• To determine the rate of inappropriate hospital admissions and days of stay in obstetric wards using the OAEP.
• To identify factors associated with inappropriate obstetric admissions and hospitalization duration.

Main Methods:

• A cross-sectional study involving the review of 2196 clinical records from seven hospitals.
• Implementation of the Obstetric Appropriateness Evaluation Protocol (OAEP) to assess admission and length of stay appropriateness.
• Logistic and linear regression models were used to analyze factors influencing inappropriateness.

Main Results:

• The mean percentage of inappropriate hospitalizations was 22%.
• Emergency admission was a protective factor (OR=0.4), while hospitalization in wards with ≥30 beds was a risk factor (OR=5.12) for inappropriate admission.
• Inappropriate admissions and large ward size (≥30 beds) increased the percentage of inappropriateness, whereas admission to Teaching Hospitals was inversely associated.

Conclusions:

• The percentage of inappropriate obstetric admissions is significantly influenced by inappropriate admission practices and the size of obstetric wards.
• Improving the management, support, and coordination of health professionals in large hospitals is crucial.
• The OAEP is a valuable tool for decision-makers to monitor and manage obstetric wards effectively.