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A controlled intervention in reduction of redundant hospital days
A Vardi1, B Modan, Z Blumstein
1Department of Clinical Epidemiology, Chaim Sheba Medical Center, Tel Aviv University Medical School, Tel Hahomer, Israel.
Insights
An intervention significantly reduced unjustified hospital stay days in pediatric patients. This approach proved effective even with lower initial unjustified stay rates in pediatric wards compared to adult wards.
Area of Science:
- Pediatric healthcare management
- Health services research
- Quality improvement in hospitals
Background:
- Inappropriate hospital service utilization, specifically unjustified hospital stay days (HSD), significantly strains healthcare budgets.
- Previous intervention studies have demonstrated success in reducing unjustified HSD within medical wards.
Purpose of the Study:
- To evaluate the effectiveness of a controlled intervention aimed at reducing unjustified hospital stay in a pediatric inpatient setting.
- To assess the impact of the intervention on key pediatric healthcare outcomes.
Main Methods:
- A controlled intervention study was conducted involving 155 pediatric inpatients and 248 controls.
- Pre-set criteria for hospitalization were applied, and results were compared to previous studies.
- Outcomes measured included unjustified HSD, out-of-hospital mortality, re-admission rates, and parental health evaluations.
Main Results:
- Unjustified HSD decreased from 32.6% to 14.8% in the intervention pediatric ward.
- The control pediatric ward saw a reduction in unjustified HSD from 25.7% to 19.3%.
- No significant differences were observed between groups in subsequent out-of-hospital mortality, re-admission, or parental health assessments one month post-discharge.
Conclusions:
- A targeted intervention program can significantly reduce unjustified hospital stay days in pediatric wards, even when initial rates are lower than in adult medical or surgical wards.
- The intervention demonstrated effectiveness without negatively impacting patient outcomes such as mortality or re-admission.
Background:
Inappropriate use of hospital services, in the form of unjustified hospital stay days (HSD), constitutes a major burden on a health budget. Reduction of unjustified HSD was achieved in a medical ward in a previous intervention study.
Methods:
A controlled intervention aimed at reducing unjustified hospital stay was performed on 155 paediatric inpatients and 248 controls, by applying pre-set criteria for hospitalization and comparing to results in previous studies.
Results:
Unjustified stay was decreased from 32.6% to 14.8% on the study ward, and from 25.7% to 19.3% on the control ward. The children on both wards did not differ significantly in rates of subsequent out of hospital mortality, re-admission, and the subjective evaluation of health by their parents one month following discharge.
Conclusions:
This study demonstrates that despite the fact that the per cent of unjustified HSD on a paediatric wars is much lower than on medicine or surgery, a significant reduction in unjustified stay can be achieved by intervention programme.