Appropriateness Evaluation of Preoperative Hospitalization: A Case Study of A Tertiary Care Hospital

Kim, Soo Young; Lee, Key Hyo; Kwon, Young Dae

Journal of Korean Society Quality Assurance Health Care 1997;4(2): 184.
Published online December 30, 1997.

수술전 재원기간의 적절성 평가

김수영¹, 이기효¹, 권영대²

¹인제대학교 보건대학원
²한국보건의료관리연구원

Appropriateness Evaluation of Preoperative Hospitalization: A Case Study of A Tertiary Care Hospital

Soo Young Kim¹, Key Hyo Lee¹, Young Dae Kwon²

¹Graduate School of Public Health, Inje University
²Korea Institute of Health Services Management

Abstract

Background
The purpose of this research was to evaluate the appropriateness of preoperative hospital days in a tertiary care hospital and to examine the reasons of the inappropriateness, so as to provide basic information and policy for enhancing appropriateness of preoperative hospitalization and benefit of patients and hospital.
Methods
The subjects of the research were the 344 patients who received operation among discharged patients during January, 1996 in surgical departments including general surgery, neurosurgery, orthopedic surgery, plastic surgery and ophthalmology. Their medical records were reviewed and appropriateness of hospital days was evaluated by the Appropriateness Evaluation Protocol.
Result
The results of evaluating the appropriateness of preoperative hospitalization showed that inappropriate hospital days were 80.8%. The reasons of inappropriate hospital stays were the tests or preparation which could be done in outpatient basis' followed by 'possible tests or preparation on the operation day' and 'cancelation of operation'.
Conclusion
In order to shorten the inappropriate preoperative length of stay, it is recommended that lengthening of laboratory running time and doing most of tests necessary for operations on the outpatient basis prior to admission should be considered. In addition, the operation at the same day of hospitalization and usage of day surgery should be encouraged. Finally there should be changes in the inpatient management system and attitudes and behaviors of surgeons to shorten unnecessary preoperative and maximize the benefit for patients and hospital.

Key words preoperative hospitalization;Appropriateness Evaluation Protocol;length of stay;