Related Experiment Video
Updated: Jul 26, 2026
Evaluation of a Point-of-Care Testing Analyzer for Measuring Peripheral Blood Leukocytes
Published on: March 22, 2022
Inappropriate hospital days of a tertiary hospital in Shanghai, China
Wenwei Liu1, Suwei Yuan2, Fengqing Wei2
1School of Philosophy, Law and Political Science, Shanghai Normal University, No. 100 Guilin Road, Shanghai 200234, China.
Insights
High rates of inappropriate hospital stays were found in Shanghai hospitals, particularly in cardiology and orthopedics. Key causes included awaiting tests, surgery, or discharge, highlighting the need for targeted interventions.
Area of Science:
- Healthcare Management
- Hospital Administration
- Quality Improvement
Background:
- Inappropriate hospital utilization contributes to increased healthcare costs and reduced quality of care.
- Assessing the extent and reasons for inappropriate hospital stays is crucial for optimizing resource allocation and patient outcomes.
Purpose of the Study:
- To determine the prevalence of inappropriate hospital days in cardiology and orthopedics departments of a Shanghai tertiary hospital.
- To identify the primary causes of these inappropriate stays.
- To analyze predictors associated with higher levels of inappropriateness.
Main Methods:
- A retrospective review of 8396 hospital days from cardiology and orthopedics departments was conducted.
- The Chinese Version of the Appropriateness Evaluation Protocol was used to audit hospital days.
- Univariate and multivariate analyses identified predictors of internal causes of inappropriateness.
Main Results:
- A significant proportion of hospital days were deemed inappropriate: 25.2% in cardiology and 40.5% in orthopedics.
- Internal causes accounted for 20.9% of inappropriate days in cardiology and 33.1% in orthopedics.
- Common reasons for inappropriateness included awaiting tests, surgery, or discharge. Predictors varied by department, including patient demographics and admission type.
Conclusions:
- The study reveals substantial rates of inappropriate hospital utilization in the studied departments.
- Findings underscore the necessity for developing and implementing targeted interventions to reduce inappropriate hospital stays and improve efficiency.
Objective:
This study aims to evaluate the prevalence of inappropriate hospital stays in a tertiary hospital in Shanghai, identify the causes for the inappropriateness and analyze the predictors.
Design:
A retrospective review of medical records.
Setting:
The cardiology and the orthopedics departments of a tertiary hospital in Shanghai, China.
Participants:
About 806 patients discharged from the cardiology or the orthopedics department of a tertiary hospital from March 2013 to February 2014.
Interventions:
Two reviewers audited 8396 hospital days of the cardiology department (n = 3606) and the orthopedics department (n = 4790) by adopting the Chinese Version of the Appropriateness Evaluation Protocol. Univariate and multivariate analysis were adopted to identify the predictors of higher levels of inappropriateness produced by internal causes.
Main Outcome Measure:
The prevalence of inappropriate hospital days.
Results:
It was found that 910 (25.2%) and 1940 (40.5%) hospital days were judged to be inappropriate in the cardiology and the orthopedics departments, respectively; and 753 (20.9%) and 1585 (33.1%) of these inappropriate hospital days were due to internal reasons, respectively. Awaiting tests, surgery or discharge were determined to constitute the main causes of inappropriateness for both departments. The predictors of higher levels of inappropriateness in the cardiology department were younger age, self-pay, outpatient admission and inappropriate admission. Self-pay, surgical and/or first-time admission patients exhibited the highest levels of inappropriateness in the orthopedics department.
Conclusions:
The rates of inappropriateness in the involved departments were relatively high. Further interventions should be designed and implemented, accordingly.
Related Concept Videos
01:21Tertiary Healthcare System
01:28Hospitals-I
00:59Hospitals-II
Nurses that work in hospitals have...