Document Detail

Cost savings and health losses from reducing inappropriate admissions to a department of internal medicine.
MedLine Citation:
PMID:  11155834     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Inappropriate hospital admissions are commonly believed to represent a potential for significant cost reductions. However, this presumes that these patients can be identified before the hospital stay. The present study aimed to investigate to what extent this is possible. METHODS: Consecutive admissions to a department of internal medicine were assessed by two expert panels. One panel predicted the appropriateness of the stays from the information available at admission, while final judgments of appropriateness were made after discharge by the other. RESULTS: The panels correctly classified 88% of the appropriate and 27% of the inappropriate admissions. If the elective admissions predicted to be inappropriate had been excluded, 9% of the costs would have been saved, and 5% of the gain in quality-adjusted life-years lost. The corresponding results for emergency admissions were 14% and 18%. CONCLUSIONS: The savings obtained by excluding admissions predicted to be inappropriate were small relative to the health losses. Programs for reducing inappropriate health care should not be implemented without investigating their effects on both health outcomes and costs.
B O Eriksen; O H Førde; I S Kristiansen; E Nord; J F Pape; S M Almdahl; A Hensrud; S Jaeger; F A Mürer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of technology assessment in health care     Volume:  16     ISSN:  0266-4623     ISO Abbreviation:  Int J Technol Assess Health Care     Publication Date:  2000  
Date Detail:
Created Date:  2001-01-11     Completed Date:  2001-02-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8508113     Medline TA:  Int J Technol Assess Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  1147-57     Citation Subset:  IM    
University Hospital of Tromsø.
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MeSH Terms
Cost Savings
Health Services Misuse / economics*
Hospital Costs
Hospital Departments / economics,  utilization*
Internal Medicine
Logistic Models
Middle Aged
Multivariate Analysis
Patient Admission / economics,  statistics & numerical data*
Quality-Adjusted Life Years
Sensitivity and Specificity
Utilization Review*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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