Gaceta sanitaria · 2007
[Impact of a clinical self-evaluation intervention on the appropriateness of hospital stays].
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Monteis Catot Jaume, Martín-Baranera Montserrat, Soler Nikita, Vilaró Josep, Moya Carlos, Martínez Francesc, Riu Marta, Puig Carme, Riba Antoni, Navarro Gemma, Espinagosa Assumpta, Carrasco Gómez Genís, Castells Xavier, Peiró Salvador
Аннотация
AIM: To assess the impact of an intervention on inappropriate hospital stays (IHS) in acute-care hospitals in Catalonia (Spain) with the aim of testing the hypothesis that a simple intervention (adeQhos) reduces the proportion of IHS.
METHODS: A pre-test/post-test study was performed through the <<adeQhos>> questionnaire. Two intervention groups (internal medicine and general surgery) and 2 control groups (other medical specialities, orthopedics) were compared in 10 acute-care hospitals in Catalonia. The same evaluators assessed appropriateness of hospital stays before and after the intervention, using the Appropriateness Evaluation Protocol.
RESULTS: A total of 1,594 pre-test stays and 1,495 post-test stays were reviewed. Of all the stays reviewed (day before discharge), 41.1% were inappropriate. The intervention was applied to 4,613 stays. There was a significant increase of IHS in the medicine control group (from 39.7 to 48.6%), and no decrease in the intervention groups (internal medicine [from 46.7 to 50.6%] or general surgery [from 27.2 to 31.2%]). The correlation between the intensity of the intervention and the difference in IHS before and after the intervention was r = -0.373 (p = 0.106). The intensity of intervention differed among the hospitals. In hospitals with an intensity of intervention > 60%, the proportion of IHS decreased by 10.7 points in internal medicine and by 4.8 points in general surgery, while the proportion of IHS increased in the control groups.
CONCLUSIONS: The prevalanece of IHS the day before discharge in the hospitals studied was high (41.1%). No significant decrease in IHS was observed after a low-intensity intervention.
METHODS: A pre-test/post-test study was performed through the <<adeQhos>> questionnaire. Two intervention groups (internal medicine and general surgery) and 2 control groups (other medical specialities, orthopedics) were compared in 10 acute-care hospitals in Catalonia. The same evaluators assessed appropriateness of hospital stays before and after the intervention, using the Appropriateness Evaluation Protocol.
RESULTS: A total of 1,594 pre-test stays and 1,495 post-test stays were reviewed. Of all the stays reviewed (day before discharge), 41.1% were inappropriate. The intervention was applied to 4,613 stays. There was a significant increase of IHS in the medicine control group (from 39.7 to 48.6%), and no decrease in the intervention groups (internal medicine [from 46.7 to 50.6%] or general surgery [from 27.2 to 31.2%]). The correlation between the intensity of the intervention and the difference in IHS before and after the intervention was r = -0.373 (p = 0.106). The intensity of intervention differed among the hospitals. In hospitals with an intensity of intervention > 60%, the proportion of IHS decreased by 10.7 points in internal medicine and by 4.8 points in general surgery, while the proportion of IHS increased in the control groups.
CONCLUSIONS: The prevalanece of IHS the day before discharge in the hospitals studied was high (41.1%). No significant decrease in IHS was observed after a low-intensity intervention.