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Please use this identifier to cite or link to this item: http://hdl.handle.net/10805/2412

Title: A multicenter study on the appropriateness of hospitalization in obstetric wards:
Authors: MANNOCCI, ALICE
Tutor: La Torre, Giuseppe
Boccia, Antonio
Keywords: appropriateness
inappropriateness
admission
hospitalization
obstetrics
Issue Date: 12-Mar-2014
Abstract: Objectives This study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol in 7 Italian hospitals to determine inappropriate hospital admissions and days of stay. Design A cross-sectional study. Methods The outcomes examined were: appropriateness/inappropriateness of admission and "percentage of inappropriateness". Results A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for a hospitalization was 22%. The percentage of inappropriateness for the first ten days of hospitalization peaked in correspondence of the 4th and 5th (42%). The emergency admission was a protective factor of inappropriated admission, OR= 0.23 95%CI (0.16-0.35). To be hospitalized in a Teaching Hospital, in a hospital with ≥30 beds and to be admitted during the Winter/Autumn and in the workweek were risk factors of inappropriateness, respectively with OR=3.50 95%CI(2.30-5.34), OR=2.04 95%CI(1.41-2.97), OR=2.14 95%CI(1.41-2.97), OR=1.85 95%CI(1.12-3.04). The linear regression model underlined that the "percentage of inappropriateness" significantly increased in inappropriate admission and in obstetric wards with ≥30 beds; the admission in a Teaching Hospital and the hospitalization in South Italy was inversely associated to the percentage of inappropriateness. The R2 model was 0.367. Conclusions The present study suggests that the percentage of inappropriate admission depends especially on the inappropriate admission and the large number of beds in obstetric wards. This suggests that the management of big hospitals, which is very complex, needs improving the processes of support and coordination of health professionals. The obstetric AEP tool seems to be an useful instrument for the decision makers to monitor and manage the obstetric wards.
URI: http://hdl.handle.net/10805/2412
Research interests: Epidemiology, Biostatistics, Health technology assessment and Public Health
Skills short description: bachelor's degree in mathematics; Master of Science in Epidemiology Catholic University of Rome, Italy; Ph.D. in “Economia e gestione delle aziende sanitarie” (Economics and Management of Health System), Catholic University of Rome, Italy
Personal skills keywords: biostatistician
epidemiologist
mathematician
public health economist
Appears in PhD:SCIENZE DI SANITA' PUBBLICA E MICROBIOLOGIA

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