title: [Not Available].
abstract: OBJECTIVE
  To assess the main features and determining factors of inappropriate admission and hospital stay in relationship with a new clinical management model.
  
  
  METHODS
  Study population included all patients discharged from the Hospital Clinic-University of Barcelona. The review tool was the medical and surgical Appropriateness Evaluation Protocol (AEP). We reviewed the clinical records of a representative sample of all discharged patients. Two independent and well trained AEP reviewers were used for each record review. A multivariate analysis was performed, using admission and inappropriate hospital stay as independent variables.
  
  
  RESULTS
  A total of 401 admissions were reviewed. Twenty-eight (6.9%) were deemed to be inappropriate. Elective admission, admission over the week-end and being admitted to a medical ward were the predictive variables identified for inappropriate admissions. Of all 2,187 hospital stays reviewed, 267 (12.2%) were deemed to be inappropriate. An inappropriate admission, total length of stay, type of insurance coverage and discharge type were the predictive variables identified for inappropriate hospital stays.
  
  
  CONCLUSIONS
  The new organization and clinical management model, developed by the Patient Focused Care Institutes, showed very acceptable levels of inappropriate admissions and hospital stays. Surgical services have benefited most from this new organization. Care provided to patients with medical conditions, notably those patients with multiple and chronic conditions, make up most of the inappropriateness identified.
authors.affiliation: Unitat d'Avaluació Suport i Prevenció (UASP). Hospital Clínic. Barcelona. España; Departament de Salut Pública. Facultat de Medicina. Universitat de Barcelona. Barcelona. España. Electronic address: aprat.@clinic.ub.es.
authors.forename: Andreu
authors.initials: A
authors.lastname: Prat
authors.forename: María J
authors.initials: MJ
authors.lastname: Bertrán
authors.forename: Manel
authors.initials: M
authors.lastname: Santiñà
authors.forename: Anna
authors.initials: A
authors.lastname: Vilella
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Asenjo
authors.forename: Antoni
authors.initials: A
authors.lastname: Trilla