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Hospital Utilization Reviews Under Field Conditions: Potential and Improvements

Published online by Cambridge University Press:  10 March 2009

Brigitte Santos-Eggimann
Affiliation:
University of Lausanne

Abstract

Hospital reviews based on an adaptation of Gertman and Restuccia's Appropriateness Evaluation Protocol were performed by acute care hospitals and the canton of Vaud (Switzerland) public health department in three settings during a six-month period in 1990–1991. Interrater agreement between hospital and public health department reviewers was measured on 1,847 days of consecutively admitted patients during the last weeks of the reviews.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1993

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References

REFERENCES

1.Boschung, D., & Sidler, M.Importance et causes de l'utilisation inappropriée identifée à l'Hôpital d'Yverdon-Ies-Bains. Lausanne: Service de la santé publique (Cah Rech Doc IUMSP 83), 1992.Google Scholar
2.Burdet, A., Perrin, J. C., Devaud, M., et al. Importance et causes de l'utilisation inappropriée identifiée à l'Hôpital de Payerne. Lausanne: Service de la santé publique (Cah Rech Doc IUMSP), 1991.Google Scholar
3.Cohen, J.A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 1960, 20, 3746.Google Scholar
4.Cohen, J.Nominal scale agreement with provision for scaled disagreement or partial credit. Psychological Bulletin, 1968, 70, 213–20.Google Scholar
5.Ermann, D.Hospital utilization review: Past experience, future directions. Journal of Health Politics, Policy and Law, 1988, 13, 683704.Google Scholar
6.Fleiss, J. L. The measurement of interrater agreement. In Fleiss, J. L. (ed.), Statistical methods for rates and proportions. New York: John Wiley and Sons, 1981, 212–36.Google Scholar
7.Gertman, P. M., & Restuccia, J. D.The Appropriateness Evaluation Protocol: A technique for assessing unnecessary days of hospital care. Medical Care, 1981, 19, 855–71.Google Scholar
8.Kalil, C., Blanc, T., & Sidler, M.Importance et causes de l'utilisation inappropriée identifiée à l'Hôpital d'Aigle. Lausanne: Service de la santé publique (Cah Rech Doc IUMSP 84), 1992.Google Scholar
9.Landis, J. R., & Koch, G. G.The measurement of observer agreement for categorical data. Biometrics, 1977, 33, 159–74.CrossRefGoogle ScholarPubMed
10.Payne, S. M. C.Identifying and managing inappropriate hospital utilization: A policy synthesis. Health Services Research, 1987, 22, 709–69.Google ScholarPubMed
11.Rishpon, S., Epstein, L. M., & Rennert, H.Unnecessary hospitalization days: Rates in two general hospitals in Israel. Israeli Journal of Medical Science, 1989, 25, 392–97.Google ScholarPubMed
12.Rishpon, S., Lubacsh, S., & Epstein, L. M.Reliability of a method of determining the necessity for hospitalization days in Israel. Medical Care, 1986, 24, 279–82.CrossRefGoogle ScholarPubMed
13.Selker, H. P., Beshansky, J. R., Pauker, S. G., & Kassirer, J. P.The epidemiology of delays in a teaching hospital: The development and use of a tool that detects unnecessary hospital days. Medical Care, 1989, 27, 112–29.CrossRefGoogle Scholar
14.Siu, A. L., Sonnenberg, F. A., Manning, W. G., et al. Inappropriate use of hospitals in a randomized trial of health insurance plans. New England Journal of Medicine, 1986, 315, 1259–66.Google Scholar
15.Strumwasser, I., Paranjpe, N. V., Ronis, D. L., et al. Reliability and validity of utilization review criteria. Appropriateness evaluation protocol, standardized medreview instrument, and intensity-severity-discharge criteria. Medical Care, 1990, 28, 95–111.CrossRefGoogle ScholarPubMed
16.Winterhalter, G., Blanc, T., & Kulczyki, E.Importance et causes de l'utilisation inappropriée identifiée à l'Hôpital de St. Loup. Lausanne: Service de la santé publique (Cah Rech Doc IUMSP), 1991.Google Scholar