Fri, Dec 9, 2022
OPEN ACCESS
Volume 21, Issue 4 ((July - August 2022)                   Payesh 2022, 21(4): 343-354 | Back to browse issues page

Ethics code: IR.ZAUMS.REC.1398.099


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Khamarnia M, Payandeh A, Keshtkaran A, Ramezani F. Inappropriate hospital admission rates after the implementation of the health system transformation plan: A cross-sectional study in southeastern Iran. Payesh 2022; 21 (4) :343-354
URL: http://payeshjournal.ir/article-1-1574-en.html
1- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
2- Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
3- Shiraz University of medical sciences, Shiraz, Iran
4- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
Abstract:   (330 Views)
Objective(s): Hospitals spend about half of the national health expenditures. Some of the costs imposed on hospitals are due to inappropriate admissions that result in a waste of resources. The purpose of this study was to estimate the inappropriate hospital admission rates in southeast of Iran during 2014 to 2019.
Methods: A cross-sectional study was conducted in the two largest hospitals of Zahedan University of Medical Sciences (ZAUMS) in 2020. The study population included patients admitted to the internal medicine and surgery wards of two teaching hospitals of which 602 persons were selected through a multi-stage sampling method. Data were collected from medical records using an Appropriate Evaluation Protocol (AEP). SPSS software (v. 24) was used to analyze the data using descriptive statistics, chi-square, and Fisher’s exact tests. P < 0.05 was considered as statistical significance.
Results: The rate of inappropriate admissions in hospitals was 8.3% and inappropriate hospital stay was 3.5%. Also, 12% of laboratory services, physician visits, nursing services and medicine in these hospitals were inappropriate. The results of chi-square test showed that the ratio of inappropriate admissions in both internal medicine and surgery wards were significantly different (P <0.05). Also, there were no any significant relationship between inappropriate admission and hospitals, age groups and gender. 
Conclusion: According to the findings, the rate of inappropriate admissions in hospitals in southern Iran is high. In order to reduce inappropriate admissions, the following suggestion might be recommended: accuracy in hospital triage, full use of referral system, and employment of specialized physicians in public hospitals.
Full-Text [PDF 1301 kb]   (105 Downloads)    
type of study: Research | Subject: Helath Service Manager
Received: 2021/01/27 | Accepted: 2022/08/1 | ePublished ahead of print: 2022/08/13 | Published: 2022/09/5

References
1. Kermani B, Gharsi M, Ghanbari B, Sarabi Asiabar A, Atefi Manesh P, Baniasadi A et al. The relationship between the levels of patient care and length of stay in hospital. Shefaye Khatam 2015; 3:33-40 [Persian] [DOI:10.18869/acadpub.shefa.3.3.32]
2. Pourreza A, Kavousi Z, Mahmoudi M, Batebi A. Admission and stays of patients based on appropriate evaluation protocol in Imam Khomeini and Dr. Shariati Hospitals of Tehran University of Medical Sciences. Journal of Health School and the Institute of Health Research 2006; 4: 74-84 [Persian]
3. BakhtariAghdam F, Vahidi R, Mohamadpour A, Kavousi Z. Admission and days of stay of patients based on the Appropriate evaluation protocol in Imam Khomeini Medical Center in Tabriz in 2006. Medical Journal of Tabriz University of Medical Sciences 2007; 30:35-39 [Persian]
4. Meydani Z, Farzandipour M,Gilasi H, Shekarchi M, Nazemi Z. Evaluation of appropriate accommodation of patients based on the Appropriate evaluation protocol in Shahid Beheshti Hospital in Kashan. Payavard Salamat 2016; 10:360-369 [Persian]
5. Aameri H, Adham D, Panahi M, Khalili Z, Fasihi A, Moraveji M, et al. Predictors of length of patient hospital stay. Health and Hygiene 2015; 6:256-265 [Persian]
6. Kouhestan SM, Hashempour R, Raei B, Chivaee D, Safari H. Prevalence and determinants of inappropriate admission and hospitalization in Iran: A systematic review and meta-analysis. Medical Journal of the Islamic Republic of Iran 2020; 34:2 [DOI:10.47176/mjiri.34.2]
7. Eivazi Y, Hamidi Y, Fazaeli A A. Study of inappropriate of admission and hospitalization and demographic factors affecting it in Shohada hospital in Kermanshah. Journal of Hospital 2021; 20 :79-87 [Persian]
8. Soltani S, Hoseini Kasnavieh M, Shaker H, Abbasian A, Amanollahi A, Tahmasebi A. Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden. Shiraz E-Medical Journal 2019; 20: 1-8 [DOI:10.5812/semj.87870]
9. Rahimi H, Ostovar R, Vali L, Angha P. Investigating inappropriate admissions and hospitalizations in Yasuj educational hospitals based on appropriateness evaluation protocol (AEP): A case study in the internal and surgical wards. The International Journal of Health Planning and Management 2019; 34:636-43 [DOI:10.1002/hpm.2723]
10. Porreza A. Salavati S, Sadeghi S. Salehi N, Tabesh H, Momivand F, et all. Factors affecting the length of stay of patients in the infectious ward of Razi Hospital in Ahvaz. Management of Health Information 2014;11: 779-788 [Persian]
11. Barooni M, Amini S, Khosravi S. Assessing the appropriateness of services provided in teaching hospitals: A case study of Kerman University of Medical Sciences. Sadra Medical Journal 2015;4: 185-194 [Persian]
12. Mahfouzpour S, Zarei A, Mehrabi Y, Ashkevari N. Evaluating the rate of unnecessary admission and hospitalization and estimating its direct financial burden: a study in the internal wards of selected hospitals of Alborz University of Medical Sciences. Health Promotion Management 2016; 6:51-57 [Persian]
13. Harirchi I. 4% increase in referral times with the start of the transformation plan. Available on http://ayaronline.ir/1395/07/209421.html] accessed 26 September 2016[ [Persian]
14. Ghasemibarghi H, Aali B, Azimi F. Evaluation of admission rate and inappropriate hospitalization days in Valiasr hospital of Meshkinshahr using AEP protocol. Journal of Iran Health Insurance 2018; 1: 39-43 [Persian]
15. Website of Tabriz University of Medical Sciences. Available on https://treatment.tbzmed.ac.ir/uploads/30/CMS/user/file/47/aennameh/140.pdf [Persian]
16. Moghadam MN, Amiresmaili M, Goudarzi R, Amini S, Khosravi S. Investigating the appropriateness of admission and hospitalization at a Teaching Hospital: A Case of a Developing Country. Iranian Journal of Public Health 2017; 46:1720-25
17. Tavakoli N, Kasnaviyeh MH, Yasinzadeh M, Amini M, Nejad MM. Evaluation of appropriate and inappropriate admission and hospitalization days according to appropriateness evaluation protocol (AEP). Archives of Iranian Medicine 2015; 18:430-4
18. Soria-Aledo V, Carrillo-Alcaraz A, Campillo-Soto Á, Flores-Pastor B, Leal-Llopis J, Fernández-Martín MP, Carrasco-Prats M, Aguayo-Albasini JL. Associated factors and cost of inappropriate hospital admissions and stays in a second-level hospital. American Journal of Medical Quality 2009; 24:321-32 [DOI:10.1177/1062860609337252]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and Permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2022 All Rights Reserved | Payesh (Health Monitor)

Designed & Developed by : Yektaweb