KMID : 1170320200260020083
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Korean Journal of Health Economics and Policy 2020 Volume.26 No. 2 p.83 ~ p.101
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Factors associated with inappropriate hospitalization days in regional public hospitals in Korea: An analysis using a two-part model
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Moon Hyun-Jung
Choi Sook-Ja
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Abstract
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Objectives: The objective was to ascertain the extent of inappropriate hospitalization days (IHDs) and to identify associated factors in public hospital inpatients.
Methods: This cross-sectional study employed concurrent and retrospective medical record reviews to examine patients (n = 800) consecutively discharged from four regional public hospitals¡¯ general care units. Three registered nurses retrospectively reviewed medical records after being trained and assessed in the use of the Korean version of the Appropriateness Evaluation Protocol (K-AEP). A two-part model (TPM) was employed with logistic and multiple regression analyses to identify the predictors of IHDs. Results: Overall, 27.5% (1,466) of the hospital days reviewed were judged to be inappropriate. Factors associated with IHDs included age, LOS, admission route, and clinical department in the first part of the model. A log-linear multiple regression analysis revealed that both LOS and undergoing surgery were significantly associated with a higher IHD rate. Delays in performing diagnostic and therapeutic procedures and stays required to undergo such procedures were the most common causes of IHDs.
Conclusions: This study showed that a substantial proportion of hospital stays was inappropriate. The characteristics associated with IHDs should be considered as criteria to promote the appropriate use of regional public hospital beds.
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KEYWORD
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Regional public hospitals, hospitalization days, appropriateness evaluation protocol, two-part model
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