Term Paper: Inappropriate Hospital Admission Raising Health Care Cost

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Inappropriate Hospital Admission Raising Health Care Cost

Inappropriate health care refers to the fact that patients are admitted in the hospitals without discerning whether there is a particular need for the admission or not. It may also be concerned with the patient's admission in the wrong type of wards or providing them with unsuitable health care. Inaccurate results have come up from surveys which had been conducted to figure out the number of inappropriate hospital admissions taking place in a given period of time and selected hospitals (Campbell, 2001).

Researchers along with several hospital administrators and policy makers feel sure that at least 20% of hospital admissions are inappropriate or are allotted unsuitably. Others assert that the rates are higher than currently anticipated. The inaccuracy and changing results are due to the diversity and non-uniformity in business settings and features and also because of the changeable applications and the assessment procedures followed in hospitals (Campbell, 2001).

The needless hospital admissions not only occupy space, wastes time and resources but also increases costs for the hospitals. The number of extra hospital admissions crowds the hospital and decreases the level of quality of health care services provided by the health care personnel. The hospital's capacity of keeping needful patients is reduced while the services of physicians who are responsible for constant attendance of the patients are somewhat wasted. Thus, it is the wide opinion of people at large that abolishing the practice of admitting unnecessary patients will not only reduce the costs for the medical organizations but it will also improve the quality of the health care services provided for those people who need it the most (Chopard, Perneger, Gaspoz, Lovis, et al. 1998).

The inappropriate hospital admissions are a cause for concern in many countries as hospital care forms a major portion of the total health care expenditures budgeted. Reports and surveys have depicted a dismal picture of inappropriate health care in many countries but the increased awareness and statistics available have also helped many hospitals to keep a check on their hospital admissions and to reduce the unnecessary ones (Chopard, Perneger, Gaspoz, Lovis, et al. 1998).

There are a number of factors that may lead to inappropriate hospital admissions so tackling this issue can mean a lot of effort and stress for many countries. Some of the factors that may decide the inappropriateness of the hospital admission include the personal characteristics of the patients, the type of organizations in which the hospital care is provided and the relationship between the hospital care system and the other parts of the health care sector. The solution of this worrying concern can only be drawn up if the risk factors that decide the inappropriateness are identified but only a small amount of studies and researches have followed this issue or taken it to a higher level (Chopard, Perneger, Gaspoz, Lovis, et al. 1998).

As it is difficult to identify the factors involved in the needless hospital admissions, the situation is far from being resolved. This, as can be expected, is leading to a rise in costs and people are targeting hospitals for being a source of increasing expenses. Developed countries often spend half of their entire health expenditure on care of patients that are admitted in hospitals, like Malaysia reportedly spends 45% of its total health expenditure on patients' care. Many economic measures and offers have been taken up and made in an attempt to curtail the escalating costs of hospital care provided. However, the subsequent effects on the quality of health care of following these measures and incentives are debatable, even if these offers have been successful in reducing costs to an extent (Chakravarty, Parmar, Bhalwar, 2005).

Instead, the use of cost-inhibiting measures is suggested for inappropriate hospital care that should not affect the quality and accessibility of the health care services provided in general. It is highly important that measures should be taken to get the maximum use out of the limited resources available to the hospital, that the unnecessary medical care be checked while the mishaps and accidents are avoided. It is substantially important that every hospital conducts a utilization review of its services as according to recent reports every one admission in three is useless and 30% of the hospital days given are unsuitable. The utilization reviews taken up by hospitals have proved informative and beneficial as they show that the admission of patients in hospitals was unnecessary and/or justifiable (Chakravarty, Parmar, Bhalwar, 2005).

DeCoster, Roos, Carriere, Peterson (1997) in their study evaluated the records kept in hospitals and tried to discern the data available into classifying the admissions of patients into 2 categories (1) appropriate and (2) inappropriate. Their research report have been extremely quite useful when it comes to depicting data as they use up a lot of information and resources while assessing the appropriateness and inappropriateness of hospital admissions (DeCoster, Roos, Carriere, Peterson, 1997).

In their study, they cite and use an example of a 1993 report that used 16 authentic Canadian and international research studies to come up with different questions to decide upon the appropriateness of hospital care. Some of the questions were "Were the admissions of patients in hospitals appropriate?" And "Were the number of days patients received in house treatment appropriate (DeCoster, Roos, Carriere, Peterson, 1997)?"

The report results of the international studies depicted that seven to forty-three percent of hospital admissions were inappropriate while around 20% to 48% days of stay were needless. The Canadian reviews that made three studies on adult patients showed that percentage of adults treated and admitted inappropriately ranged from 24% to a whopping 90% while as much as 66% of days of stay were unnecessary with a minimum percentage of stay being 27% (DeCoster, Roos, Carriere, Peterson, 1997).

Patients who were receiving care were also reviewed at the Manitoba Centre for Health Policy and Evaluation (MCHPE) and 26 Manitoba hospitals were visited for the review in the year 1993-94. The findings of the report also revealed that 51% of the hospital admissions and sixty-seven percent of the days of stay for adults with examined medical conditions were deemed to be unnecessary or inappropriate (DeCoster, Roos, Carriere, Peterson, 1997).

This article will also attempt to use the terms "acute" and "non acute" which can be used interchangeably for appropriate and inappropriate. This paper revolves around the issue of non-acute care given to patients and how it has contributed in increasing hospitals costs and has led to the inefficient use of resources and finance. The effects and ways to resolve the adverse effects of non-acute hospital care will also be examined in this paper.

Literature Review

Inappropriate hospital admissions during the 1990's

The management of hospitals and other health care providing centers is primarily concerned with the provision of efficient, effective and appropriate care and medical attendance given to patients. In spite of this concern, during the 1990's, very little attention was paid to the acuteness of the care a patient needs at the time of admissions and under review, hospitals were revealed to have admitted quite a large percentage of non-acute patients (Coast, Peters and Inglis, 1996).

The reports that showed an almost 25% of inappropriate admissions in hospitals generally were drawn up with skewed methods and it is probable that they may not be realistic. Moreover, these kinds of reviews and reports totally chose to ignore the effect of varying factors on the initial admissions in hospital. Other reports came up with varying results; with some depicting 5% of the admissions inappropriate while some even claiming that 60% of the admissions were non-acute (Coast, Peters and Inglis, 1996).

The studies taken up in the period of 1960s and thereafter mainly questioned and investigated the issue of inappropriate stay in hospital beds. These studies had been characterized by the problems related to the discharging of patients and the issues related to bed blocking which is the unnecessary stay of a patient in the hospital lasting for more than a month, or specifically 28 days. These reviews had also given importance to the factors that played a major role in admitting patients to the hospitals and problems that followed inappropriate stays (Coast, Peters and Inglis, 1996).

Patients afflicted with some mental disease or dementia are more likely to stay for non-acute reasons in the hospitals. Other factors which may make the patients stay in a hospital inappropriately include immobility, progressing age factor, problems attributed to self-care, gender (females are more likely to be inappropriate admissions by the hospitals as compared to males), marital status, type of accidents, the loneliness of patients and so on (Coast, Peters and Inglis, 1996).

The significant issue for the public policy makers and cost reducing programs is whether the inappropriateness of the health care services provided has anything to do with the changeable admission rates in different hospitals. If this link is confirmed, then the need for costly reviews is eliminated as the sources of data in population based area can be used… [END OF PREVIEW]

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