title: Predictors of inappropriate hospital stay: experience from Iran.
abstract: OBJECTIVE
  Hospital services are the most expensive component of modern health care systems and inappropriate hospital stay is one of the most important challenges facing hospitals in many countries. The purpose of this study was to determine the extent of inappropriate hospital stay and investigate the related factors in Semnan city (Iran).
  
  
  METHODS
  In this study, the Iranian version of Appropriateness Evaluation Protocol (AEP) was used in a representative sample of 300 hospital admissions and 905 hospital days. Data collection was performed during six weeks in January and February 2014 in four wards (two internal medicine and two surgical wards) of two hospitals in Semnan city (Iran).
  
  
  RESULTS
  The results showed that 7.4% of admissions and 22.1% of stays have been inappropriate. Inappropriate stays were mainly concerned to the factors, including length of stay, inappropriate admissions, as well as factors related to hospitals. The most frequent causes of unjustifiable days were due to waiting for diagnostic or therapeutic procedures (35.1%), and 20.6% delay in discharge of patients by physicians due to conservative medical policy.
  
  
  CONCLUSIONS
  In conclusion, this study confirms the existence of inappropriate hospital stays which may be due to patient characteristics and hospital factors. The most unjustifiable reasons for inappropriate hospital stay were related to internal processes of hospital, which mostly could be prevented through appropriate management Therefore, some steps must be taken to decrease inappropriate hospital stay and preserve hospital resources for patients who need them.
authors.forename: Ali Asghar
authors.initials: AA
authors.lastname: Ghods
authors.affiliation: . rkhabiri@razi.tums.ac.ir.
authors.forename: Roghayeh
authors.initials: R
authors.lastname: Khabiri
authors.forename: Nayereh
authors.initials: N
authors.lastname: Raeisdana
authors.forename: Mehry
authors.initials: M
authors.lastname: Ansari
authors.forename: Nahid
authors.initials: N
authors.lastname: Hoshmand Motlagh
authors.forename: Malihe
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Ehsan
authors.initials: E
authors.lastname: Zarei
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006739:Hospital Administration / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007492:Iran; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012959:Socioeconomic Factors; D055815:Young Adult