EVALUATION OF THE APPROPRIATENESS OF HOSPITAL STAY IN GYNECOLOGICAL WARDS IN TABRIZ TEACHING HOSPITALS

Abstract

Objective: The increasing demand for health care services together with the increasing cost of providing them supports the need for a reconsideration of the existing structures. This study evaluated the appropriateness of hospital stay in gynecological wards. Methodology: This is a descriptive-analytic study which was conducted in 2006-2007 by using modified appropriateness evaluation protocol. Results: The average duration of hospital stay for 402 patients was 55.18 +/- 45.03 hours. The length of hospital stay was inappropriate in 61.2%. The main reasons for unnecessary stay before surgery included: no prior outpatient preparation of patients for operation, inadequate diagnostic procedures and the problems resulting from urgent admission (OR=2.91, CI=1. 53-5.28, OR=1.56, CI=1.10-2.99 and OR=1.01, CI=0.08-2.58 respectively). The most important factors for inappropriate stay after surgery included: patient's home-hospital distance and delayed physician's order for discharge (OR=4.18, CI=2.57-13.20 and OR=2.06, CI=1.02-4.43). Conclusions: Inappropriate hospital stay was 61.2%, and it could be decreased to 28.10% by using appropriate approaches.