Doyle M, Barrett B J, McDonald J, McGrath J, Parfrey P S
Memorial University of Newfoundland, St. John's.
Healthc Manage Forum. 1998 Fall;11(3):15-25. doi: 10.1016/S0840-4704(10)60665-5.
Hospital efficiency is closely related to utilization levels and length of stay. This study determined whether inappropriate bed utilization in Newfoundland was related to inefficiency or inadequate access to alternative services. It also compared Canadian Institute for Health information (CIHI) data to our survey to determine whether they provide comparable information for monitoring efficiency. Inappropriate acute care days were identified using a modified Appropriateness Evaluation Protocol. Average length of stay (ALOS) by service for each of the province's acute care institutions was also reviewed from 1993-94 to 1995-96 using the CIHI database. Hospital admissions were Inappropriate in 14.2 percent of 2,007 cases. Of the 14,194 days of care, 22.8 percent were inappropriate, with most (16.4 percent) being avoidable with better use of existing resources. Of the inappropriate days, 49.2 percent related to physicians' functions. The provincial ALOS fell from 5.70 days in 1993-94 to 5.39 days in 1995-96, but remains 10.5 percent above the national average.
医院效率与利用率水平和住院时间密切相关。本研究确定了纽芬兰不适当的床位使用是否与效率低下或无法充分获得替代服务有关。它还将加拿大卫生信息研究所（CIHI）的数据与我们的调查进行了比较，以确定它们是否能提供用于监测效率的可比信息。使用改良的适宜性评估方案确定了不适当的急性护理天数。还利用CIHI数据库对该省各急性护理机构1993 - 94年至1995 - 96年期间按服务划分的平均住院时间（ALOS）进行了审查。在2007个病例中，14.2%的医院入院是不适当的。在14194个护理日中，22.8%是不适当的，其中大多数（16.4%）可以通过更好地利用现有资源避免。在不适当的天数中，49.2%与医生的职能有关。该省的平均住院时间从1993 - 94年的5.70天降至1995 - 96年的5.39天，但仍比全国平均水平高10.5%。
