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[内科病房住院的适宜性——采用适宜性评估方案]

[Appropriateness of hospitalization in a ward of internal medicine--using the Appropriateness Evaluation Protocol].

作者信息

Vieira Nuno B, Rodríguez-Vera Javier, Ferrão Estela, Taveira Teresa, Monteiro Luísa, Grade Maria J, Duarte Isidoro, Arez Luísa

机构信息

Serviço de Medicina (Sector1), Centro Hospitalar do Barlavento Algarvio, Portimão.

出版信息

Acta Med Port. 2006 Jan-Feb;19(1):67-70. Epub 2006 Apr 30.

Abstract

INTRODUCTION

The Appropriateness Evaluation Protocol (AEP) is an instrument to study the appropriate use of hospital beds based in objective criteria that classify a hospital admission as appropriate or inappropriate.

OBJECT

Evaluate the appropriateness of hospital admissions and stays of the patients of our Internal Medicine Department using the concurrent version of AEP.

METHOD

Transversal study where was evaluated the clinical record of the patients admitted to our Department of Internal Medicine on March 13th of 2003, excluding all these who were admitted the day of the study. We analyzed demographic and clinic parameters and the appropriateness of hospital admission and stay using the AEP.

RESULTS

22 patients fulfilled the inclusion criteria, 54.5% of male gender with a average age of 70.7 years. All the admissions were considered appropriate. The most common criteria was the need of intravenous therapy (100%), followed by the sudden lost of corporal mobility (12.3%). 27.3% of stays were considered inappropriate on the day of the study. The most common criteria of appropriateness was the need of intravenous therapy (93.7%). The most usual reason of inappropriate stay was the existence of planned discharge, but without the order written down in the clinical file (66.7%).

CONCLUSIONS

The AEP allows an efficient evaluation of the appropriateness of the hospital admissions and stays in a Health Unit, being used for a better utilization of resources. In our department all admissions were justified and about a quarter of stays were considered inappropriate using the AEP.

摘要

引言

适宜性评估方案(AEP)是一种基于客观标准研究医院床位合理使用情况的工具,该标准将医院入院情况分为适宜或不适宜。

目的

使用AEP的同期版本评估我们内科患者的医院入院及住院的适宜性。

方法

进行横断面研究,评估2003年3月13日入住我们内科的患者的临床记录,排除研究当天入院的所有患者。我们分析了人口统计学和临床参数,以及使用AEP评估的医院入院及住院的适宜性。

结果

22名患者符合纳入标准,男性占54.5%,平均年龄70.7岁。所有入院情况均被认为是适宜的。最常见的标准是需要静脉治疗(100%),其次是身体活动突然丧失(12.3%)。在研究当天,27.3%的住院情况被认为是不适宜的。适宜性最常见的标准是需要静脉治疗(93.7%)。住院不适宜最常见的原因是存在计划出院,但临床文件中未记录医嘱(66.7%)。

结论

AEP能够有效评估健康单元中医院入院及住院的适宜性,有助于更好地利用资源。在我们科室,使用AEP评估所有入院情况都是合理的,约四分之一的住院情况被认为是不适宜的。

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