University Hospital of Liège, Liège, Belgium.
Health Policy. 2011 Jan;99(1):66-71. doi: 10.1016/j.healthpol.2010.06.011. Epub 2010 Aug 5.
The objective is to evaluate the use of the Appropriateness Evaluation Protocol (AEP) as a screening tool for determining the causes of the non-justified days to help hospitals to decrease the length of stay while preserving the quality of care.
Three successive cross-sectional surveys were conducted from 2003 till 2005, in 23 Belgian hospitals. During this period, 10921 days were audited by means of the AEP. This study is focused on adult acute non-intensive care units. The appropriateness of each day of the sample was assessed, and for those considered as inappropriate, the reasons explaining the prolongation of the stay were investigated.
The proportion of inappropriate days was 24.61%. There is a high variability across specialties and hospitals. Regarding inappropriate days, the analysis of causes of prolongation, globally, by bed index or by hospital, indicated clearly internal and external factors that lengthen stays. The most frequent reasons are waits for an examination (22%) and the lack of extra-hospital structures (31%).
The use of AEP as a tool of internal audit to measure the proportion of non-justified days and their causes turns out to be possible and the obtained results has provided some accurate and useful information for the participating, and allowed them to take concrete decisions which lead to shrinking of the length of hospital stay.
本研究旨在评估适宜性评估方案（AEP）作为一种筛查工具，以确定非合理住院日的原因，从而帮助医院在保持护理质量的同时缩短住院时间。
2003 年至 2005 年，在 23 家比利时医院中连续进行了 3 项横断面研究。在此期间，通过 AEP 对 10921 天的住院情况进行了审核。本研究重点关注成人急性非重症监护病房。评估样本中每一天的适宜性，并对被认为不适宜的住院日，调查导致住院时间延长的原因。
不合理住院日的比例为 24.61%。各科室和医院之间存在高度的变异性。对于不合理的住院日，通过床位指数或医院对延长住院时间原因的分析，明确指出了内部和外部因素会导致住院时间延长。最常见的原因是等待检查（22%）和缺乏院外机构（31%）。
使用 AEP 作为内部审计工具来衡量非合理住院日的比例及其原因是可行的，所获得的结果为参与研究的医院提供了一些准确和有用的信息，并促使他们做出具体决策，从而缩短了住院时间。
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