1. [Organizational appropriateness evaluation of hospital discharges related to DRGs at high risk of inappropriateness in a pediatric observation ward from 2000 to 2004].
- Author
-
Celestini E, Filocamo A, Prota F, Di Roma S, Passafaro S, Langiano T, Fara GM, and Guasticchi G
- Subjects
- Adolescent, Child, Child, Preschool, Efficiency, Organizational, Female, Hospitalization statistics & numerical data, Humans, Infant, Infant, Newborn, Length of Stay statistics & numerical data, Male, Medical Records, Program Evaluation, Retrospective Studies, Rome, Severity of Illness Index, Diagnosis-Related Groups statistics & numerical data, Emergency Service, Hospital statistics & numerical data, Health Services Misuse statistics & numerical data, Hospitals, Pediatric statistics & numerical data, Patient Discharge statistics & numerical data
- Abstract
The aim of the study is to measure and to describe organizational appropriateness of a Paediatric Temporary Observation Ward in the Emergency Department. We selected hospital discharges related to 43 DRGs at high risk of inappropriateness (DPCM 29/11/2001); we studied the relationship between appropriateness and patient's or discharge characteristics. We also investigated the inappropriateness to find tools for improving ward's efficiency. Assessment of selected paediatric clinical records was performed using PRUO protocol and showed that 41.5% of hospital discharges are completely appropriated and only 13.8% are completely not appropriated and, consequently, could be provided in a different organizational setting. Inappropriateness in our study is lower than the expected one; this finding shows that the ward under investigation is able to provide health assistance with good level of appropriateness. The used tool to evaluate appropriateness is a modified PRUO version, specific for pediatric hospital stays. Pediatric PRUO protocol is easy to be applied even if reasonable and shared evaluation criteria do not seem able to recognise some peculiar characteristics of Pediatric Temporary Observation Ward in the Emergency Department.
- Published
- 2007