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ORIGINAL ARTICLE
Year : 2017  |  Volume : 6  |  Issue : 3  |  Page : 121-124

Evaluating inappropriate patient stay and its reasons based on the appropriateness evaluation protocol


1 Health Information Management Research Center, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran
2 Department of Pediatric Surgery, Imam Hossein Children Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
4 Head of Medical Record Department, Shahid Ayatollah Ashrafi Isfahani, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Nursing Services, Senior Nurse (matron) of Shahid Beheshti University Hospital, Kashan University of Medical Sciences, Kashan, Iran

Correspondence Address:
Davood Kheirkhah
Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/nms.nms_16_17

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Background: Hospital beds are among valuable resources for care delivery. Therefore, optimum use of them is crucial for increasing the efficiency of health-care services and controlling health-care costs. Objective: This study intended to evaluate inappropriate patient stay (IPS) in hospital settings and its reasons based on the appropriateness evaluation protocol. Methods: This cross-sectional study was conducted on 335 patients hospitalized in a tertiary care university hospital. Data were gathered prospectively by 13 hospital nurses during a 6-month period. IPS rate was evaluated using a checklist, the 27 criteria of which were related to medical services, nursing/life support services, and patient's conditions. Moreover, a 12-item checklist was used to determine physician-, hospital-, and patient/family-related factors behind inappropriate hospital stay. Results: In total, 121 of 1925 (6.3%) hospitalization days of 335 patients were determined to be inappropriate. Neurosurgery and gynecology wards had the highest and the lowest inappropriate hospital stay rates (22.5% vs. 0%), respectively. The main reasons behind inappropriate hospital stay were hospital-related factors (33.1%), physician-related factors (29.1%), and patient-related factors (21.3%). Conclusion: A wide variety of physician-, hospital-, and patient/family-related factors contribute to IPS. Given the multifactorial causes of IPS, reducing its rate necessitates multidisciplinary approaches.


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