Inappropriate hospital admission rates after the implementation of the health system transformation plan: A cross-sectional study in southeastern Iran

Hospitals spend about half of the national health expenditures. Some of the costs imposed on hospitals are due to inappropriate admissions that result in a waste of resources. The purpose of this study was to estimate the inappropriate hospital admission rates in southeast of Iran during 2014 to 2019.

A cross-sectional study was conducted in the two largest hospitals of Zahedan University of Medical Sciences (ZAUMS) in 2020. The study population included patients admitted to the internal medicine and surgery wards of two teaching hospitals of which 602 persons were selected through a multi-stage sampling method. Data were collected from medical records using an Appropriate Evaluation Protocol (AEP). SPSS software (v. 24) was used to analyze the data using descriptive statistics, chi-square, and Fisher’s exact tests. P < 0.05 was considered as statistical significance.

The rate of inappropriate admissions in hospitals was 8.3% and inappropriate hospital stay was 3.5%. Also, 12% of laboratory services, physician visits, nursing services and medicine in these hospitals were inappropriate. The results of chi-square test showed that the ratio of inappropriate admissions in both internal medicine and surgery wards were significantly different (P <0.05). Also, there were no any significant relationship between inappropriate admission and hospitals, age groups and gender. 

According to the findings, the rate of inappropriate admissions in hospitals in southern Iran is high. In order to reduce inappropriate admissions, the following suggestion might be recommended: accuracy in hospital triage, full use of referral system, and employment of specialized physicians in public hospitals.