Evaluation of Unnecessary Admissions and Hospital Stays and Estimation of Its Financial Burden: A Study at Internal Wards of Selected Hospitals of Alborz University of Medical Sciences

Controlling inappropriate use of health services is one of the ways to limit health care costs without sacrificing services’ quality. The aim of this study was to evaluate unnecessary admissions and hospital stays and to estimate its financial burden in selected hospitals of Alborz University of Medical Sciences.
In this descriptive study, 310 patients admitted to the internal wards of two hospitals were selected using the quotas sampling from July to September 2014. The data collection tool was the Appropriateness Evaluation Protocol questionnaire that its validity and reliability were confirmed. Data analysis was performed using the SPSS 18 software.
The results showed that 8.5% of admissions and 9.9% of hospital stays were unnecessary, and 20.3% of the patients had at least one unnecessary hospitalization day. The most important reasons for the unnecessary stay were waiting for the results of clinical diagnostic tests and delays in timely visits of the physicians. The amount of financial burden due to unnecessary hospitalization during three months of study was 125,928,000 Rials, as well as the financial burden arising from the absence of work for patients due to unnecessary stay was equal to 24,241,600 Rials.
Part of hospital resources is wasted due to unnecessary admissions and stays. Increasing non-hospital care facilities to reduce referrals to higher-level centers, refinement of incomplete care’s processes through quality improvement practices, and the establishment of physician-resident plans in hospitals are recommended for reducing unnecessary admissions and hospital stays.