Unnecessary hospitalization days: rates in two general hospitals in Israel

The efficient use of hospital resources is an important issue. In order for the hospital management to identify definite areas where and why this use is inefficient, the Appropriateness Evaluation Protocol is used. The rate of unnecessary hospitalization days was thus studied during 1984 in two government general hospitals in Israel. Two simultaneous studies, cross-sectional and longitudinal, were conducted by the same team in the general medicine, surgery and gynecology wards. Unnecessary hospitalizations were found in both hospitals. The rate was particularly high in the surgery departments of the university hospital where there were 2.5-3 times more unnecessary days than in the community hospital. The major reasons for these unnecessary days in the university hospital were internal (problems concerning the use of diagnostic facilities, operating rooms and consultants), whereas in the community hospital they related mainly to discharge planning. The study identified definite areas in which hospital authorities could possibly take action to reduce the wastage.