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

Authors

• Daniel Louis
• Francesco Taroni
• Rita Melotti
• Carol Rabinowitz
• Maria Vizioli
• Monica Fiorini
• Joseph Gonnella

Publication/Presentation Date

10-1-2008

Abstract

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.

Volume

13

Issue

4

First Page

202

Last Page

208

ISSN

1355-8196

Published In/Presented At

Louis, D., Taroni, F., Melotti, R., Rabinowitz, C., Vizioli, M., Fiorini, M., & Gonnella, J. (2008). Increasing appropriateness of hospital admissions in the Emilia-Romagna region of Italy. Journal of health services research & policy, 13(4), 202–208. https://doi.org/10.1258/jhsrp.2008.007157

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

18806177

Department(s)

Administration and Leadership

Document Type

Article