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Short-stay study--utilization review.

R A Myers, J S Britten, R T Grassi

    The Journal of Trauma
    |March 1, 1983
    PubMed
    Summary
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    Approximately 20% of patients admitted to the Maryland Institute for Emergency Medical Services Systems (MIEMSS) had short stays under 48 hours. Of these, 13% were deemed inappropriate admissions, a rate lower than regional trauma centers.

    Area of Science:

    • Emergency Medicine
    • Healthcare Management
    • Trauma Care

    Background:

    • Short-stay admissions can indicate potential inefficiencies in patient triage and resource allocation within emergency medical systems.
    • Understanding the rate and reasons for short stays is crucial for optimizing patient flow and care quality.

    Purpose of the Study:

    • To determine the percentage of short-stay admissions (less than 48 hours) at the Maryland Institute for Emergency Medical Services Systems (MIEMSS).
    • To assess the clinical appropriateness of these short-stay admissions.
    • To compare the rate of inappropriate admissions at MIEMSS with areawide trauma centers in Maryland.

    Main Methods:

    • Retrospective analysis of patient admission data over a 6-month period.
    • Inclusion criteria: patients admitted to MIEMSS who did not die during their stay.

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  • Clinical review to determine the appropriateness of admissions lasting less than 48 hours.

    • Main Results:

    • Approximately 20% of 589 non-deceased patients admitted to MIEMSS had stays under 48 hours.
    • Two-thirds of these short stays (13% of total admissions) were judged clinically inappropriate.
    • The rate of inappropriate admissions at MIEMSS was lower than the 20% rate observed at Maryland's areawide trauma centers.

    Conclusions:

    • The rate of inappropriate short-stay admissions at MIEMSS is relatively low and may represent unavoidable triage errors.
    • Inappropriately admitted patients did not significantly impact MIEMSS resources or the care of critically ill patients.
    • Findings suggest efficient triage processes at MIEMSS compared to broader regional trauma care standards.