title: A multicenter study on the appropriateness of hospitalization in obstetric wards: application of Obstetric Appropriateness Evaluation Protocol (Obstetric AEP).
abstract: The cross-sectional study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol (OAEP) in seven hospitals to determine inappropriate hospital admissions and days of stay. The outcomes were: inappropriateness of admission and "percentage of inappropriateness" for one hospitalization. A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for hospitalization was 22%. The percentage of inappropriateness for the first 10 d of hospitalization peaked in correspondence of the fourth (42%). The logistic regression model on inappropriated admission reported that emergency admission was a protective factor (OR = 0.4) and to be hospitalized in wards with ≥30 beds risk factor (OR = 5.12). The second linear model on "percentage of inappropriateness" showed that inappropriated admission and wards with ≥30 beds increased the percentage (p < 0.001); whereas the admission in Teaching Hospitals was inversely associated (p < 0.001). The present study suggests that the percentage of inappropriate admission depends especially on the inappropriate admission and the large number of beds in obstetric wards. This probably indicates that management of big hospitals, which is very complex, needs improving the processes of support and coordination of health professionals. The OAEP tool seems to be an useful instrument for the decision-makers to monitor and manage the obstetric wards.
authors.affiliation: a Department of Public Health and Infectious Diseases , "Sapienza" University of Rome , Rome , Italy .
authors.forename: Alice
authors.initials: A
authors.lastname: Mannocci
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Specchia
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Poppa
authors.forename: Giovanni
authors.initials: G
authors.lastname: Boccia
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Cavallo
authors.forename: Francesco
authors.initials: F
authors.lastname: De Caro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vetrano
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Aleandri
authors.forename: Mario
authors.initials: M
authors.lastname: Capunzo
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
authors.forename: Antonio
authors.initials: A
authors.lastname: Boccia
authors.forename: Alberto
authors.initials: A
authors.lastname: Firenze
authors.forename: Antonio
authors.initials: A
authors.lastname: Malvasi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Torre
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D015337:Multicenter Studies as Topic; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D012040:Regional Health Planning
keywords: Appropriateness evaluation protocol; appropriateness of hospital use; inappropriateness; obstetrics