ABSTRACT
It has been carried out a survey to evaluate the appropriateness of hospital stay in a university hospital. The aims of the study were: to determine the amount of inappropriate hospital admissions and inappropriate days of stay in relation to either wards and characteristics of admission; to analyse the reasons for inappropriate patient stay. A randomised sample stratified by ward of discharge of 224 medical records were analysed using the Italian version of the Appropriateness Evaluation Protocol. 37.9% of the hospital admissions and 18.9% of hospitalisation days were judged to be inappropriate. The main reasons for categorising an admission or a day of stay as inappropriate were a) delay in performing elective surgery procedures; b) that the patient's problem could be treated on an outpatient basis; c) delay in performing diagnostic examinations. The univariate statistical analysis showed an association between appropriateness of hospital stay and gender age, ward of discharge, length of hospital stay and DRG type (medical/surgical). The study highlights a lower level of inappropriateness compared to the results of other investigations. Hints were also identified for achieving an improved efficiency at hospital level.
Subject(s)
Hospitals, University/statistics & numerical data , Length of Stay , Patient Admission/standards , Adolescent , Adult , Aged , Analysis of Variance , Child , Child, Preschool , Female , Health Surveys , Hospitalization/statistics & numerical data , Hospitals, University/standards , Humans , Infant , Infant, Newborn , Italy , Male , Medical Records , Middle Aged , Utilization ReviewABSTRACT
The authors realized a retrospective clinical-statistical study about 121 cases of acute myocardial infarction (AMI), treated in the Department of general medicine with a pharmacological association of Lysine acetylsalicylate--Erythrityl tetranitrate--Papaverine hydrochloride, with the purpose of obtaining a vasodilatation on coronary arteries and a platelet antiaggregation, in the light of the new etiopathogenetic views about the prolonged coronary spasm and the platelet aggregation, in some cases of myocardial infarction with or without thrombosis. Obtained data are very optimistic about incidence of left ventricular insufficiency and (of) thromboembolisms, to they augur the sistematic adoption of this treatment of AMI, especially as to the early antiaggregation therapy.
