Evidence map›Paper›PMID 31818835›Full record

ArticleBMJ open2019

Assessment of appropriateness of hospitalisations in Ukraine: analytical framework, method and findings.

Feng Zhao, Olena Doroshenko, Valery N Lekhan, Lilia V Kriachkova, Alona Goroshko

Abstract readComparative Study
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Feng ZhaoHNP, World Bank Group, Washington, District of Columbia, USA.
Olena DoroshenkoHNP, World Bank Group, Kyiv, Ukraine inglecasket@gmail.com.ORCID 0000-0002-0741-2863
Valery N LekhanDepartment of Social Medicine and Health Management, Dnipropetrovsk Medical Academy (DMA), Dnipro, Ukraine.
Lilia V KriachkovaDepartment of Social Medicine and Health Management, Dnipropetrovsk Medical Academy (DMA), Dnipro, Ukraine.
Alona GoroshkoDepartment for Development of Benefits Package, National Health Service of Ukraine, Kyiv, Ukraine.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis article reviews the applicability of a customised version of the Appropriateness Evaluation Protocol (AEP) to evaluate the magnitude of inappropriate hospitalisations in two regions of Ukraine. DATA AND

methodsThe original AEP was modified to develop a customised tool, which included criteria for the appropriateness of hospitalisation and duration of inpatient stay. The customisation of the tool followed the Delphi procedure. We randomly selected 381 medical records to test the feasibility and reliability of the method and 800 medical records to evaluate the scope of inappropriate hospitalisations. We used descriptive and analytical statistics, receiver operating characteristic curve analysis and Cohen's kappa to check the consistency between the findings of primary reviewers and experts.

resultWe observed high levels of agreement in conclusions of primary reviewers (reference standard) and experts during testing of the reliability and validity of the method. The external validity check showed that the use of the tool by different experts provided high accuracy: 95.1 sensitivity, 76.6 specificity and area under ROC-curve (AUC)=0.948 (р<0.001) for analysis of the appropriateness of admissions; 95.3 sensitivity, 84.7 specificity and AUC=0.900 (р=0.001) for the duration of hospitalisations. Cohen's kappa coefficient (

conclusionThe proposed method is robust in assessing the appropriateness of hospitalisations and duration of inpatient stays. The quantified levels of unnecessary hospital care indicate the need for improving efficiency and quality of care and optimising the excessive hospital capacities in Ukraine.

Indexed as

Health Services MisuseHospital DepartmentsHumansMedical RecordsPatient AdmissionQuality Assurance, Health CareReproducibility of ResultsROC CurveSensitivity and SpecificityUkraineavoidable hospitalizationshospital admissionsreliability and validity of the methodUkraine version appropriateness evaluation protocol (AEP)unjustified inpatient stay

Identifiers

PMID31818835
PMCPMC6924815

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.