Reliability and Validity of the Appropriateness Evaluation Protocol for Public Hospitals in Korea
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives: This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea. Methods: In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared. Results: The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively. Conclusions: Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.
Abstract
Objectives: This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea. Methods: In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared. Results: The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively. Conclusions: Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.
참고문헌 (30)
- Donabedian A, "The quality of care. How can it be assessed?", JAMA, 260(12), pp.1743~1748 (1988)
- Lohr KN, "A strategy for quality assurance in Medicare", N Engl J Med, 322(10), pp.707~712 (1990)
- "InterQual® level of care criteria"[URL]
- Gertman PM, "The appropriateness evaluation protocol : a technique for assessing unnecessary days of hospital care", Med Care, 19(8), pp.855~871 (1981)
- "Criteria"[URL]
- Esmaili A, "Developing of the appropriateness evaluation protocol for public hospitals in Iran", Iran Red Crescent Med J, 17(3), pp.e19030~ (2015)
- Liu W, "Reliability and validity of the Chinese version appropriateness evaluation protocol", PLoS One, 10(8), pp.e0136498~ (2015)
- Lorenzo S, "Reliability study of the European appropriateness evaluation protocol", Int J Qual Health Care, 11(5), pp.419~424 (1999)
- Robain M, "Reliability and validity of the French version of the first part of the appropriateness evaluation protocol(AEPf) : pertinent criteria of hospitalization stay", Rev Epidemiol Sante Publique, 47(2), pp.139~149 (1999)
- Apolone G, "Appropriateness of hospital use : report from an Italian study", Eur J Public Health, 7(1), pp.34~39 (1997)
- Kaya S, "Liability and validity of the appropriateness evaluation protocol in Turkey", Int J Qual Health Care, 12(4), pp.325~329 (2000)
- Lang T, "A European version of the appropriateness evaluation protocol : goals and presentation", Int J Technol Assess Health Care, 15(1), pp.185~197 (1999)
- Jepsen HK, "Every seventh acute medical admission is preventable", Dan Med J, 60(3), pp.A4595~ (2013)
- Panis LJ, "To stay or not to stay. The assessment of appropriate hospital stay: a Dutch report", Int J Qual Health Care, 14(1), pp.55~67 (2002)
- Sangha O, "Metric properties of the appropriateness evaluation protocol and predictors of inappropriate hospital use in Germany : an approach using longitudinal patient data", Int J Qual Health Care, 14(6), pp.483~492 (2002)
- Santos-Eggimann B, "Medical appropriateness of hospital utilization : an overview of the Swiss experience", Int J Qual Health Care, 7(3), pp.227~232 (1995)
- Sánchez-García S, "The hospital appropriateness evaluation protocol in elderly patients : a technique to evaluate admission and hospital stay", Scand J Caring Sci, 22(2), pp.306~313 (2008)
- Esmail A, "Development of the paediatric appropriateness evaluation protocol for use in the United Kingdom", J Public Health Med, 22(2), pp.224~230 (2000)
- Chan SC, "Appropriateness of medical admissions from a Malaysian public primary care clinic", Med J Malaysia, 54(3), pp.329~337 (1999)
- Leung LP, "Who should be admitted to hospital? Evaluation of a screening tool", Hong Kong Med J, 14(4), pp.273~277 (2008)
- Hwang JI, "Characteristics of patient and healthcare service utilization associated with inappropriate hospitalization days", J Adv Nurs, 60(6), pp.654~662 (2007)
- Yoem HY, "Appropriateness evaluation of hospitalization for the cerebral ischemia patients", J Korean Acad Community Health Nurs, 10(1), pp.80~92 (1999)
- Modernization of public district general hospitals: 2011 modularization of Korea’s development experience, "Oh J", Ministry of Strategy and Finance, 19~21 (2012)
- Landis JR, "The measurement of observer agreement for categorical data", Biometrics, 33(1), pp.159~174 (1977)
- Tavakoli N, "Evaluation of appropriate and inappropriate admission and hospitalization days according to appropriateness evaluation protocol(AEP)", Arch Iran Med, 18(7), pp.430~434 (2015)
- Gamper G, "Inappropriate hospital admission : interaction between patient age and co-morbidity", Intern Emerg Med, 6(4), pp.361~367 (2011)
- Menand E, "French multicenter evaluation of the appropriateness of admission to the emergency department of the over-80s", J Nutr Health Aging, 19(6), pp.681~687 (2015)
- Andrew MK, "An approach to ‘the social admission’", Can J Gen Intern Med, 10(4), pp.20~22 (2015)
- Mould-Quevedo JF, "Direct costs associated with the appropriateness of hospital stay in elderly population", BMC Health Serv Res, 9, pp.151~ (2009)
- Rojas-García A, "Impact and experiences of delayed discharge : a mixed-studies systematic review", Health Expect, 21(1), pp.41~56 (2018)
