بررسی اقامت مقتضی بیماران بر اساس پروتکل ارزیابی مقتضی بودن در بیمارستان شهید بهشتی کاشان

Background and Aim: In attention to hospital beds serves as an invaluable resource in health system and necessity for appropriate hospital beds utilization through the reduction of patient inappropriate stay, this study aimed to assess the proportion and causes for hospital inappropriate stays.  Materials and Methods: The proportion and causes for hospital inappropriate stays were analyzed in a cross-sectional survey using a sample of 1925 days of hospital stay based on the Appropriateness Evaluation Protocol. The study was conducted at the tertiary care University Hospital Shahid Beheshti, 510 – bed teaching hospital which is located in the central part of Iran. Results: Hundred and twenty one days (6.3%) of 1925 days of patient hospitalization were inappropriate. There was relationship between inappropriate stay and patients’ age and types of insurance. Findings relating to analysis of patient non demographic causes revealed that among hospitals, physicians and patient causes, Hospital-related causes and Physicians related causes have the most impact 42 (33.1%) and 37 (29.1%) on patient inappropriate stay  respectively.  Conclusion: AEP list of reasons provides base line data for performance improvement in health care organizations. For conducting improvement process, developing a multidisciplinary team under title of Utilization Review committee is recommended to pave the way for targeted interventions based on identified potential causes.