Development of the Paediatric Appropriateness Evaluation Protocol for use in the United Kingdom.
BACKGROUND
This paper describes a study to develop and test an instrument to measure the level of appropriate admissions and days of care in the paediatric hospital population.


METHODS
The American version of the Paediatric Appropriateness Evaluation Protocol (PAEP) was modified by the consensus views of a panel of paediatricians and general practitioners. Reliability was tested in a pilot study in a random sample of 47 admissions from two district general hospitals.


RESULTS
The agreement beyond chance for the raters using the PAEP for admission criteria was excellent (kappa = 0.848). It was poor (kappa = 0.345) for clinicians using subjective judgement. The agreement beyond chance for the day of care criteria was good (kappa =0.54). Trained reviewers achieved much higher reliability using the PAEP.


CONCLUSIONS
The modified PAEP achieved high reliability and was judged acceptable by clinicians to retrospectively assess the appropriateness of admissions in the UK setting.
School of Primary Care, Faculty of Medicine, University of Manchester, Rusholme Health Centre, UK.
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Esmail
D002648:Child; D017408:Guidelines as Topic; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006767:Hospitals, District; D006769:Hospitals, General; D006776:Hospitals, Pediatric; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D020380:Needs Assessment; D015588:Observer Variation; D010343:Patient Admission / Q000706:statistics & numerical data*; D018579:Patient Selection; D010865:Pilot Projects; D012017:Referral and Consultation; D012720:Severity of Illness Index; D013222:State Medicine; D006113:United Kingdom; D014600:Utilization Review / Q000458:organization & administration*