ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne1997
Inappropriate hospital use by patients receiving care for medical conditions: targeting utilization review.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 68 citations in OpenAlex.
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- Inappropriate hospital admission: interaction between patient age and co-morbidity.Internal and emergency medicine · 2011Article
- Administrative data and the manitoba centre for health policy: some reflections.Healthcare policy = Politiques de sante · 2011Article
- Characteristics of patients in a ward of Academic Internal Medicine: implications for medical care, training programmes and research.Internal and emergency medicine · 2010Article
- Appropriateness of acute admissions and last in-patient day for patients with long term neurological conditions.BMC health services research · 2009Article
- Factors associated with patients who leave acute-care hospitals against medical advice.American journal of public health · 2007Article
- Determining appropriateness for rehabilitation or other subacute care: is there a role for utilisation review?Australia and New Zealand health policy · 2007Article
- Appropriateness of admission and length of stay in a Turkish Military Hospital.Journal of medical systems · 2004Article
- Does universal comprehensive insurance encourage unnecessary use? Evidence from Manitoba says "no".CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2004Article
- Discharges against medical advice: time to address the causes.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2002Article
- How valid are utilization review tools in assessing appropriate use of acute care beds?CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2000Article
- The need for acute, subacute and nonacute care at 105 general hospital sites in Ontario. Joint Policy and Planning Committee Non-Acute Hospitalization Project Working Group.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1998Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe characteristics associated with inappropriate hospital use by patients in Manitoba in order to help target concurrent utilization review. Utilization review was developed to reduce inappropriate hospital use but can be a very resource-intensive process.
designRetrospective chart review of a sample of adult patients who received care for medical conditions in a sample of Manitoba hospitals during the fiscal year 1993-94; assessment of patients at admission and for each day of stay with the use of a standardized set of objective, nondiagnosis-based criteria (InterQual). PATIENTS: A total of 3904 patients receiving care at 26 hospitals. OUTCOME MEASURES: Acute (appropriate) and nonacute (inappropriate) admissions and days of stay for adult patients receiving care for medical conditions.
resultsAfter 1 week, 53.2% of patients assessed as needing acute care at admission no longer required acute care. Patients 75 years of age or older consumed more than 50% of the days of stay, and 74.8% of these days of stay were inappropriate. Four diagnostic categories accounted for almost 60% of admissions and days, and more than 50% of those days of stay were inappropriate. Patients admitted through the emergency department were more likely to require acute care (60.9%) than others (41.7%). Patients who were Treaty Indians had a higher proportion of days of stay requiring acute care than others (45.9% v. 32.8%). Patients' income and day of the week on admission (weekday v. weekend) were not predictive factors of inappropriate use.
conclusionRather than conducting a utilization review for every patient, hospitals might garner more information by targeting patients receiving care for medical conditions with stays longer than 1 week, patients with nervous system, circulatory, respiratory or digestive diagnoses, elderly patients and patients not admitted through the emergency department.
Indexed as
Identifiers
9327796PMC1228213W2132098019What OpenQuestion holds
Registered trials
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.