| Titre : | Effectiveness of a physician-oriented feedback intervention on inappropriate hospital stays. (2007) |
| Auteurs : | Pedro ANTON ; Jesus-M ARANAZ ; Rafael CALPENA ; Antonio COMPAN ; Edith LEUTSCHER ; Salvador PEIRO ; Vicenta RUIZ ; Fundacion Instituto de Investigacion en Servicios de Salud. Valencia. ESP ; Inspeccion de Servicios Sanitarios. Elche. ESP |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 61, n° 2, 2007) |
| Pagination : | 128-134 |
| Langues: | Anglais |
| Mots-clés : | Efficacité ; Médecin ; Profession santé ; Rétroaction ; Hospitalisation ; Homme |
| Résumé : | [BDSP. Notice produite par INIST-CNRS ESR0xXS8. Diffusion soumise à autorisation]. Objective : To evaluate the effectiveness of a combined intervention to reduce inappropriate hospital stays. Design : Quasi-experimental pre-test/post-test with a non-equivalent control group. Setting : Three teaching hospitals in the National Health System in Alicante, Spain. Study participants : Intervention group (2 Surgical Units with 1451 hospital stays) and control group (1 Surgical Unit with 1268 hospital stays). Intervention : Structured oral presentation followed by direct feedback to surgeons about their own percentages of inappropriate stays and daily evaluation of appropriateness by the surgeons during their rounds. Main outcome measures : Reduction in the percentage of inappropriate stays identified by the Appropriateness Evaluation Protocol during the intervention period compared to the basal period. Results : The intervention group reduced its percentage of inappropriate stays from 14.3% to 7.9% (absolute reduction : - 6.40 ; 95% Cl - 10.7 to - 2.14 ; relative reduction : 44.8%), while no changes occurred in the control group. The reduction was in the number of inappropriate stays attributable to the patients'medical management that went from 12.7% to 5.8% (absolute reduction : - 6.92 ; 95% Cl-10.90 to - 2.92), while no significant changes occurred in inappropriate stays due to other causes. Conclusions : A combined intervention of feedback and physician participation in appropriateness evaluations is effective in reducing the percentage of inappropriate hospital stays, particularly those attributable to conservative medical patterns at discharge. |
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