Abstract
BackgroundAgeing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated.MethodsAppropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP). Direct medical costs associated with hospital stay under the third-party payer's institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS), in Mexico City.ResultsThe sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9–5.8) of hospital stay, of which 12.4% (n = 90) were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6 – 2.7). The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89). The mean cost for an appropriate hospitalization per patient resulted in US$1,497.2 (95% CI = US$323.2 – US$4,931.4), while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US$2,323.3 (95% CI = US$471.7 – US$6,198.3), (p < 0.001).ConclusionElderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management.
Highlights
Ageing of Mexican population implies greater demand of hospital services
Ageing of the Mexican population is one of the higher impact phenomena which began manifesting during the XX Century, and which will undoubtedly be an essential element in the creation of the history of Mexico in the XXI Century
This study reported a 12% rate of inappropriate hospitalization use, which falls within the 5% to 74% [18,20,21,22,23,24,25,26] ranges reported in literature
Summary
Ageing of Mexican population implies greater demand of hospital services. The direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated. Ageing of the population will imply a greater demand of health services, as a consequence of the high rates associated morbidity. Among the diseases of the elderly population are chronic-degenerative conditions, that make them fragile and turns them into a population that utilize many health services. It is well known that part of the hospital resources are used inadequately, either because the patients receive assistance that does not turn into health benefits or because care services could be provided at different institutional levels representing lower costs [2,3]
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