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|Title: ||A multicenter study on the appropriateness of hospitalization in obstetric wards:|
|Authors: ||MANNOCCI, ALICE|
|Tutor: ||La Torre, Giuseppe|
|Issue Date: ||12-Mar-2014|
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.
A cross-sectional study.
The outcomes examined were: appropriateness/inappropriateness of admission and "percentage of inappropriateness".
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.
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.|
|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|
public health economist
|Appears in PhD:||SCIENZE DI SANITA' PUBBLICA E MICROBIOLOGIA|
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|Tesi di dottorato di ricerca Mannocci A.pdf||Tesi di dottorato||276.1 kB||Adobe PDF|
File del Curriculum Vitae:
|CurriculumVitae.pdf|| ||274.27 kB||Adobe PDF|
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