Utilidad del Pediatric Appropriateness Evaluation Protocol para detectar deficiencias de circuitos asistenciales hospitalarios

Abstract

To quantify the number of inappropriate pediatric hospital admissions using the Pediatric Appropriateness Evaluation Protocol (pAEP), the causes of inappropriate admissions, and the clinical utility of the paep, as well as to detect deficiencies in the healthcare circuit in hospitalized pediatric patients. A prospective, descriptive study was carried out in a sample of 236 pediatric admissions. We analyzed several items such as age, pAEP, factors associated with inappropriate admission, main and secondary diagnoses, the diagnostic tests motivating admission, and day of the week and month of admission. A total of 13.6 % (CI: 9.5 %-18 %) of pediatric admissions were inappropriate. The most frequent reasons for inappropriate admissions were diagnostic tests (2.5 %) and treatment (11 %) that could have been performed on an outpatient basis. Most (90.6 %) of the admissions deemed inappropriate by the pAEP were also considered inappropriate when evaluated by experienced pediatricians. Improvement of healthcare circuits could decrease inappropriate admissions (better coordination between primary care and hospitals and improved access from the emergency unit to the specialized pediatric outpatient service). The pAEP allows identification of inappropriate admissions and their causes, as well as detection of deficiencies in the healthcare circuit.