Key result
In a tertiary hospital in Wuhan, 23.31% of surgical hospital days were deemed inappropriate, with admission from outpatient being a strong predictor of postoperative inappropriate days (OR 5.724).
Why the study?
The study aimed to analyze the frequency, associated factors, and specific reasons for inappropriate hospitalization days to provide evidence for reducing inappropriate hospital days in a tertiary hospital.
Cross-Sectional (n=408)
No
Inappropriate hospital days are highly prevalent among surgical patients in China, driven primarily by medical factors such as conservative management and delays in inspections or operations.
Background The first step in every quality improvement process is the identification the problem and its extent. We aim to analyze the frequency and its associated factors of inappropriate hospitalization for a tertiary hospital in Wuhan and ascertain the specific reasons for each IHDs to provide evidence for further reduction of inappropriate hospital days. Results A total of 4586 days of hospital stay from 408 cases were evaluated by A cross-sectional and retrospective audit program carried out in a third-level teaching hospital with 5613 beds and 9623 faculty in Wuhan, China. 320 cases (78.43%) were reported to have experience at least one IHD and 1053 hospital days (23.31%) were found to be inappropriate. Predictors of higher levels of inappropriateness with surgery were patients at the age of 60-69(OR=2.328, 95% CI=1.359-3.989) before the surgery, and use of ventilators(OR=2.127, 95%CI=1.116-2.839), admission from outpatient(OR=5.724, 95%CI=1.579-20.744), multiple diagnosis(OR=1.604, 95%CI=1.059-2.432), and higher surgical incision level(OR=2.152, 95%CI=1.391-3.327) after surgery. The main causes of inappropriateness were medical factors that were related to the healthcare services providers, however, the patient factors gave rise to nearly a quarter of IHDs after surgery. Conclusions The prevalence of IHDs was 23.31% in this tertiary hospital in Wuhan. Findings from this study indicate that the characteristics of surgical patients from different phases(preoperative/postoperative) are supposed to be taken into account to develop efficient and feasible interventions for IHD reduction.
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Li et al. (2021) conducted a cross-sectional in Surgical patients (laparoscopic cholecystectomy, spine fusion implantation, laparoscopic lobectomy) (n=408). Admission from outpatient vs. Admission from emergency or other routes was evaluated on Inappropriate hospitalization days (IHDs) after surgery (OR 5.724, 95% CI 1.579-20.744, p=0.008). In a tertiary hospital in Wuhan, 23.31% of surgical hospital days were deemed inappropriate, with admission from outpatient being a strong predictor of postoperative inappropriate days (OR 5.724).
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