Journal of Health Services Research & Policy > Volume 13, Number 4 > Pp. 202-208

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Louis, D. Articles by Gonnella, J. Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?

Original research

Increasing appropriateness of hospital admissions in the Emilia-Romagna region of Italy

Daniel Louis , Francesco Taroni ¹, Rita Melotti ², Carol Rabinowitz, Maria Vizioli ³, Monica Fiorini ⁴, Joseph Gonnella

Jefferson Medical College, Philadelphia, Pennsylvania, USA; ¹ Department of Social Medicine, University of Bologna, Bologna, Italy; ² Department of Anaesthesiology, University of Bologna, Bologna, Italy; ³ Regione Emilia-Romagna, Bologna, Italy; ⁴ Agenzia Sanitaria Regionale Regione Emilia-Romagna, Bologna, Italy

Correspondence to: Daniel.louis{at}jefferson.edu

Objectives: The Emilia-Romagna region of Italy has reduced the number of available hospital beds and introduced financial incentives to curb hospital use. The goal of this study was to assess the impact of these policies on changes over time in the number of acute hospital admissions classified in diagnosis related groups (DRGs) that could be treated safely and effectively in alternative, less costly settings.

Methods: The assessment of the appropriate site of care was based on analysis of hospital discharge data for all hospitals for the selected diagnosis related groups in the Emilia-Romagna region for 2001 to 2005. The necessity for acute hospital admission was based on the severity of a patient's principal diagnosis, co-morbid diseases and, for surgical admissions, procedure performed.

Results: From 2001 to 2005, potentially inappropriate medical admissions of more than one day decreased from 20,076 to 11,580, a 42% decrease. Inappropriate admissions decreased in both public and private hospitals but there remained a higher rate of inappropriate admissions to private hospitals. Potentially inappropriate medical admissions accounted for 128,319 bed-days in 2001 and 68,968 bed-days in 2005, a reduction of 59,351 bed-days. Potentially inappropriate surgical admissions decreased from 7383 in 2001 to 4349 in 2005, a 41% decrease. Bed-days consumed by inappropriate surgical admissions decreased from 23,181 in 2001 to 13,660 in 2005.

Conclusions: The Emilia-Romagna region has succeeded in reducing the use of acute hospital beds for patients in selected diagnosis related groups. However, there are still substantial numbers of admissions that could potentially be treated in less costly settings.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?