Inappropriate admission and hospitalization in teaching hospitals of Tehran University of Medical Sciences, Iran

Objective: To determine the appropriateness of admission and hospitalization of patients in two major teaching hospitals of Tehran University of Medical Sciences (TUMS). Methodology: Appropriateness Evaluation Protocol was employed to evaluate 1732 days of hospital stay and 258 patient admissions. Results: Findings indicated that 22.8% of admissions were inappropriate and length of stay for patients who had inappropriate admissions was significantly shorter than those who had appropriate admission. Statistical tests demonstrated a significant difference between hospital wards in terms of inappropriate admission (p<0.0001). On average 8.6% of patient days were inappropriate and it is significantly different between two hospitals. It was also found that the more patient length of stay, the more inappropriate patient day. Delay in discharge process was the most frequent reason indicated for inappropriate hospital stay. Conclusions: A substantial proportion of hospital admissions and stays were found to be inappropriate due to management procedures and more likely lack of health care services in lower level of health system.