Inappropriate Hospital Stay of Patients Admitted Under Care of General Medicine Units: A retrospective study

Objective: This study aims to assess the incidence of inappropriate hospital stay and to identify reasons behind inappropriate hospitalisation. Methods: The study was a retrospective cohort study included patients admitted under the care of General Internal Medicine. First, we calculated the average length of hospital stay for all included patients, and then we used Appropriateness Evaluation Protocol to examine admissions that exceeded the average length of hospital stay and then identify reasons for the inappropriate hospital stay. Results: There were 854 admissions during the study period. In this cohort, 53.1% were men, and the median age was 64 (IQR:44-75) years. There was a total of 6785.4 hospitalization days, and the average length of hospital stay was 5 (IQR:3-9) days. 31.9% of admissions (n=272 admissions) included inappropriate hospitalization days. 9.9 % (n=674 days) of hospitalization days were classified as inappropriate. Delay in complementary tests (29.0%), and unavailability of extra-hospital resources (21.7%) were the most common reasons associated with inappropriate hospital stay. Old Age was associated with increased inappropriate hospital stay. Conclusion: A significant proportion of hospitalisation days were inappropriate due to hospital related factors. Therefore, auditing hospital services, and investing in home-based care are among the top strategies which are likely to improve early discharge and minimize inappropriate hospital bed occupancy. Keywords: Hospital Stay; Hospitalization, patient discharge; General Internal Medicin