Predictors of inappropriate hospital stay: a clinical case study.

Abstract

To assess the reasons for inappropriate patient stay (IPS) and to identify possible predictors of this inappropriate stay. The reasons for IPS were analyzed in a cross-sectional survey at two surgical one gynecologic and one obstetric ward, using a sample of 610 days of hospital stay by means of the Dutch Appropriateness Evaluation Protocol. The study was conducted at the University Hospital Maastricht, a 715-bed hospital with a regional and teaching function, located in the southern part of The Netherlands. Results indicate that > 20% of the hospital stay was inappropriate. The reasons for IPS were statistically significantly related to the patients' age, the availability of home care and medical specialty. In a predictive model, only the specialty proved to be a predictor of IPS. Most of the IPS occurred during the first days of hospital stay and the days before the patient's discharge. A substantial proportion of hospital stay was found to be inappropriate, due to hospital procedures and the inability to refer patients to other care facilities or care providers. Analysis of the causes of IPS provided useful data for improvement actions. Efficient use of hospital resources should be promoted by reducing the delay in interventions and discharge procedures.