Appropriateness Of Inpatient Days Research Based On Appropriateness Evaluation Protocol

Objective: This research taked two diseases of rectal malignancy and acute myocardial infarction in a grade A tertiary public hospital as examples,and aims to evaluate the suitability of inpatient days for sample patients according to Appropriateness Evaluation Protocol(AEP).This paper grasped the current distribution of appropriate and inappropriate hospitalization days,explored the causes and influencing factors of inappropriate hospitalization days.Finally the countermeasures and methods to reduce the inappropriate inpatient days were comprehensively discussed from various perspectives,so as to provide references for strengthening patient hospitalization management and reasonably reducing the average inpatient days of patients.Methods:The patients with rectal malignancy and acute myocardial infarction in gastrointestinal surgery and cardiology departments were selected as research objects,a total of 4999 hospitalization days were selected for the two diseases.All inpatient hospital days were evaluated retrospectively using the Appropriateness Evaluation Protocol(AEP),the evaluation indicators suitable for hospitalization days and the causes of inappropriate hospitalization days were recorded,and a multifactorial analysis of the influencing factors of inappropriate hospitalization days was conducted.Results:In terms of appropriate hospitalization days,the most frequently used indicators for patients with rectal malignancy were B2,B4,B6,the most frequently used patients with acute myocardial infarction were B2,B4,A10.In terms of inappropriate inpatient days,the hospitalization days of patients with rectal malignancy and acute myocardial infarction included in the suitability evaluation were 3142 and 1857 days,among which the inappropriate hospitalization days were 269 and 136 days,respectively,accounting for8.56% and 7.32% of the total hospitalization days.The major causes of inappropriate hospitalization for the two diseases were waiting for examination,waiting for surgery and untimely discharge.Days of hospitalization,admission season,discharge ward,and payment method were the influencing factors of inappropriate inpatient days for patients with rectal malignancy,as well as the admission route and hospitalization days were the risk factors of the length of inappropriate inpatient days for patients with acute myocardial infarction(P<0.05).Conclusion: The use of various indicators in the evaluation protocol varied slightly for different types of patients.The inappropriate inpatient days of the sample hospitals are generally at a low level,but there is still room for further optimization,as well as the causes and risk factors involved many aspects of doctors and patients.It is suggested that multiple measures should be taken according to the causes,reasonably shorten the average hospitalization days by reducing the occurrence of inappropriate hospitalization days,this can not only economize the cost burden and time cost of inpatients,but also contribute to advance the economic and social benefits of the hospital.