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Identifying inappropriate hospital stay in patients with venous thromboembolism.
MedLine Citation:
PMID:  15066647     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Traditionally, venous thromboembolism has been treated in a hospital setting. Nowadays, low molecular weight heparin (LMWH) preparations allow most deep venous thrombosis (DVT) patients to benefit from home therapy. The objective of this study was to evaluate whether the previous treatment of deep venous thrombosis in a hospital setting was appropriate in the context of modern opinion, using the Dutch Appropriateness Evaluation Protocol (DAEP). If so, the DAEP could be used to assess the appropriateness of the present hospital stay of other patient groups. Methods: A retrospective study of patients treated from 1995 to 1998 for DVT or for pulmonary embolism (PE), before the implementation of ambulatory treatment, was conducted that assessed the appropriateness of the patient's hospital stay using the DAEP. Results: Only 27.1% of the treatments for DVT were found to be appropriate in a hospital setting and related to specific hospital care. Inappropriate stay was mostly related to delays in hospital and discharge procedures. Of the patients with PE, 50.2% needed a hospital stay. This proportion was statistically significantly higher than in DVT patients (p<0.001). The extent of the DVT was not related to the length of bed rest prescribed. Conclusions: The DAEP was able to identify inappropriate hospital stay in the past within the DVT patient group. Further exploration of the potential of the DAEP to identify patient groups who could be treated at home is warranted.
Authors:
Lambert J.G.G. Panis; Dinanda N. Kolbach; Karly Hamulyák; Martin H. Prins
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  European journal of internal medicine     Volume:  15     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-Apr-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  39-44     Citation Subset:  -    
Affiliation:
Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Post Box 5800, 6202 AZ, Maastricht, The Netherlands.
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