[Reliability and validity of the French version of the first part of the Appropriateness Evaluation Protocol (AEPf): pertinent criteria of hospitalization stay].
BACKGROUND
The Appropriateness Evaluation Protocol (AEP) is a tool used to identify hospitalization days that are appropriate with respect to simple technical criteria, and the reasons for hospitalization days that do not meet these criteria. The goal of the study was to validate the clinical criteria of AEPf, required for identifying the reasons which explain these inappropriate hospital days.


METHODS
The validity of a French version of criteria of appropriateness (AEPf) was assessed in a sample of 502 hospital days in medical and surgical wards of six French teaching hospitals. The reliability of the AEPf-based conclusions was studied by the measure of the concordance between two independent measures of AEPf for the same hospital day. Validity of AEPf was studied by the measure of the concordance between AEPf-based conclusions and the judgments of physicians using implicit criteria to assess the necessity of the hospital day studied. The degree of concordance was estimated by the Kappa coefficient.


RESULTS
AEPf reproducibility was high (Kappa coefficient: 0.81; 95% confidence interval (95% CI): 0.76-0.87). Validity was also high (Kappa coefficient: 0.61; 95% CI: 0.53-0.68).


CONCLUSIONS
The French version of the AEP was thus shown to be both reliable and valid to identify hospitalisation days appropriate with respect to hospital's technical equipment and specific resources. However, the reproducibility of the assessment of reasons for hospital days that did not meet AEP criteria will require a validation.
Robain
M
M
SIM, CHU Pitié-Salpétrière (AP-HP), Paris.
Lang
T
T
Fontaine
A
A
Logerot
H
H
Monnet
E
E
Six
P
P
Huet
B
B
D016009:Chi-Square Distribution; D005260:Female; D005602:France; D006748:Hospital Departments / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D014175:Translating; D014600:Utilization Review / Q000379:methods* / Q000592:standards
Reproductibilité et validité de la version française de la première partie de l'Appropriateness Evaluation Protocol (AEPf): critères de pertinence des journées d'hospitalisation.