Inappropriateness of Hospital Admission, Hospital Stay and Bed Utilization at Monufia University Hospitals, Egypt

Background:Worldwide, inappropriate hospital admission and stay is one of the most important challenges facing all health systems. Objectives:The current study aimed to estimate frequency of inappropriate admission and stay, determine risk factors associated with inappropriateness and study the bed utilization patterns in 2016atMonufia University Hospitals.Methods:A total number of 350 patients (1637 days) admitted to various departments of Monufia University Hospitals were included in this cross-sectional study. Patients were interviewed, their hospitalization days were assessed by Appropriateness Evaluation Protocol (AEP) and their records were analyzed.
Results: Percentages of inappropriate hospital admission and stay were 18.3% and 18.6% respectively. General surgery department had the highest rate of inappropriateness (32.8%). Admission to avoid the waiting time for an outpatient investigation was the most common reason of inappropriate admission (48.4%),while waiting for surgical procedure was the most common reason of inappropriate pre-procedure hospital stay (64.2%) and conservative practice was the most common reason of inappropriate post-procedure hospital stay (58.4%). Overall bed occupancy rate was 76.39% and average hospital stay was 4.12 days. Inappropriate admission was related to rural residency and to patients living >10 km away from the hospital, while inappropriate stay was related to older age >50 y and long hospital stay.
Conclusion: The most common reason of inappropriate hospitalization was unorganized hospital schedules of treatment and discharge of patients. Proper monitoring of length of stay (LOS) and bed utilization rates can early detect any hospitalization defect and thus improve hospital efficiency.