[Appropriate use of hospital days in medical wards].
BACKGROUND
This study evaluated the incidence of inappropriate use of bed days in Danish medical wards using the European Appropriateness Evaluation Protocol (AEP). Several European countries have used the AEP to assess the appropriateness of hospitalisation days.


METHODS
The study was carried out in four Danish medical wards from October 2004 to January 2005. On pre-selected days a doctor and nurse performed case record analyses of all hospitalised patients with registration of the AEP criteria. To assess activities during the entire day, the screening comprised activities from the previous day.


RESULTS
Altogether, 738 patients were reviewed. On average, 32.1% of hospitalisation days on the four wards were assessed as inappropriate (range 19.2-39.2%). Lack of alternative facilities (different outpatient services, rehabilitation, home nursing, etc.) and internal waiting time for diagnostic tests were the most common causes of inappropriate bed use. 6.4% of bed days were considered appropriate from a clinical point of view even though no AEP criteria were met.


CONCLUSIONS
In order to reduce the number of inappropriate hospital days, it is necessary to optimise the cooperation with the primary health care sector and ensure immediate availability of diagnostic tests.
Rasmussen
Lisbeth
L
pqlr@stofanet.dk
Münter
Dorte
D
Bøttcher
Charlotte
C
Jacobsen
Oli
O
Larsen
Kiss
K
Marcussen
Henrik
H
Møller
Marianne Kleis
MK
Nørregaard
Peter
P
Nørskov
Bente
B
D003718:Denmark; D017598:Efficiency, Organizational; D005060:Europe; D006300:Health Services Misuse; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D007902:Length of Stay; D010343:Patient Admission; D010347:Patient Care Planning / Q000458:organization & administration*; D014600:Utilization Review / Q000379:methods*; D014850:Waiting Lists