Appropriateness of Hospital Utilization

Assessing the appropriateness of hospital utilization in the United Kingdom may yield practical solutions to problems faced by both purchasers and providers of health care in the National Health Service. It is, however, essential that such assessment is based on a method that is both valid and reliable--in particular, valid in the context in which it is applied. Whereas American methods for the assessment of appropriateness have been shown to be valid in the United States, it is pertinent to question whether the application of such methods to the National Health Service also is valid given the different circumstances, both cultural and financial, under which health care is provided. A study of the appropriateness of admission and hospital stay for a sample of admissions to a large acute hospital in the United Kingdom was carried out, and the assessment of appropriateness was made using the Intensity-Severity-Discharge Review System with Adult criteria (ISD-A). The validity and reliability of using the ISD-A for assessing hospital utilization in the United Kingdom was evaluated. The ISD-A was found to have high reliability and to be valid for assessing appropriateness in the United Kingdom when a full range of alternative forms of care are presumed to be available. It was not found to be valid currently, therefore, for routine assessment of hospital utilization within the National Health Service, when alternatives often are not available

Acute care · Appropriateness criteria · Business · Context (archaeology) · Health care · Reliability (semiconductor) · Service (business) · Emergency and Acute Care Studies · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Medicine

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  Joanna Coast, A Inglis et al.•Journal of Epidemiology and…•1995

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• Effectiveness of a physician-oriented feedback intervention on inappropriate hospital stays

  Open Access•Pedro Antón, Salvador Peiró et al.•Journal of Epidemiology and…•2007

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• Assessing the Extent to Which Hospitals Are Used for Acute Care Purposes

  Carolyn DeCoster, Sandra Peterson et al.•Medical Care•1999

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• A Coefficient of Agreement for Nominal Scales

  Open Access•Jacob Cohen•Educational and Psychological…•1960

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• Reliability and Validity of Utilization Review Criteria

  Ira Strumwasser, Nitin V Paranjpe et al.•Medical Care•1990

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• Enhancing appropriateness of acute bed use

  I Harvey, Renee R Jenkins et al.•Journal of Epidemiology and…•1993

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• The Reliability and Application of Clinical Judgment in Evaluating the Use of Hospital Beds

  Rachel Rosser, Rachel M Rosser•Medical Care•1976

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• Reliability of a Method of Determining the Necessity for Hospitalization Days in Israel

  Shmuel Rishpon, Sharon Lubacsh et al.•Medical Care•1986

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• The Appropriateness Evaluation Protocol

  Paul M Gertman, Joseph D Restuccia•Medical Care•1981

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