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(frequency rate = 17.0 admissions/100 rooms) and 7015 stay days (hospitalization rate =
218.3 stays/100 rooms), 18.9% of the admissions and 49.9% of the stays were evaluated
as inappropriate. Hospitalization was associated with a worse health condition,
institutionalization, male sex, certain pathologies and previous health services usage.
Patients characteristics were not associated with the percentage of inappropriate stays.
97.5% of inappropriate stays were attributed to hospital scheduling problems and
physicians' practices. CONCLUSIONS: Socio-demographic factors, morbidity, health
condition and previous health service usage are shown as good hospitalization predictors
for senior citizens, but these factors are not related to inappropriate hospitalization usage.
4/7 von 41 DIMDI: MEDLINE (ME66) © NLM
ND: 21649772
PMID: 11791416
Autoren: Katz M; Warshawsky SS; Porat A; Press J
Titel: Appropriateness of pediatric admissions to a tertiary care facility in Israel.
Quelle: The Israel Medical Association journal : IMAJ; VOL: 3 (7); p. 501-3 /200107/
SU: IM
Sprache: English
CY: Israel
JID: 100930740
ISSN: 1565-1088
CO: IMAJCX
Institution: Center for Medical Decision Making, Faculty of Health Sciences, Ben-Gurion University of
the Negev, Israel.
DT: Journal Article
Schlagwörter
CT: AGE FACTORS; CHILD; CHILD, PRESCHOOL; DELIVERY OF HEALTH
CARE/STANDARDS; EVALUATION STUDIES; FEMALE; HOSPITALS/STANDARDS;
HUMAN; INFANT; INFANT, NEWBORN; ISRAEL; LENGTH OF STAY; MALE; PATIENT
ADMISSION/*STANDARDS; PEDIATRICS/*STANDARDS; PROSPECTIVE STUDIES;
REFERRAL AND CONSULTATION/STANDARDS; SUPPORT, NON-U.S. GOV'T
CTG: Altersfaktoren; Kind; Kind, Vorschul-; Gesundheitsversorgung/Standard;
Evaluationsstudien; Weiblich; Krankenhäuser/Standard; Mensch; Kleinkind; Kind,
neugeborenes; Israel; Krankenhausaufenthaltsdauer; Männlich;
Patientenaufnahme/*Standard; Pädiatrie/*Standard; Prospektive Studien; Überweisung und
Konsultation/Standard; Support, Non-U.S. Gov'T
AB: BACKGROUND: Appropriateness of hospital admission has both clinical and economic
relevance, especially in light of the growing pressure for increased efficiency of health
services utilization. In Israel, the number of referrals and use of the emergency room
continue to rise along with an increase in hospital admissions and the number of
inappropriate admissions. Using evaluation protocols, such as the Pediatric
Appropriateness Evaluation Protocol, international studies have shown that 10-30% of
hospital admissions are medically unnecessary. Inappropriate hospitalizations have an
economic impact as well as medical and psychological effects on the child and the family.
OBJECTIVES: To assess the extent and characteristics of inappropriate pediatric
admissions to a tertiary care facility in Israel. METHODS: We conducted a prospective
study using chart review of pediatric admissions to Soroka University Medical Center on 18
randomly selected days in 1993, and evaluated the appropriateness of admissions using
the PAEP. RESULTS: Of the 221 pediatric admissions 18% were evaluated as
inappropriate. The main reason for such an evaluation was that the problem could have
been managed on an ambulatory basis. Inappropriate admissions were associated with
hospitals stays of 2 or less days, children older than 1 year of age, Jewish children, and
self-referrals to the pediatric emergency room. CONCLUSIONS: The assessment and
identification of characteristics of inappropriate hospital admissions can serve as indicators
of problems in healthcare management and as a basis for improving quality of care and
developing appropriate medical decision-making processes.
4/8 von 41 DIMDI: MEDLINE (ME66) © NLM
ND: 21564719
PMID: 11708397
G-AEP_Bericht_703.doc-22.08.2003-38