Utilizacion inapropiada de la hospitalizacion pediatrica

Objective: Our aim was to identify the inappropriate utilization of pediatric hospitalization, its reasons and associated factors. Patients and methods: Three hundred twenty-three medical records were randomly selected among the patients aged 6 months to 14 years and hospitalized in 1995 in a public hospital of the Community of Valencia. The validated Spanish version of the Pediatric Appropriateness Evaluation Protocol was retrospectively applied. The proportions of inappropriate admissions and stays and their reasons were estimated and their association with certain factors analyzed. Results: Of the admissions 17.7% (95% CI: 13.5 - 21.8) and 15.5% of the stays (95% CI: 11.5-19.4) were considered inappropriate. The most frequent reason for inappropriate admission was that diagnostic and therapeutic needs might have been solved by ambulatory care. Inappropriate stays were in mot cases (70%) due to that doctors did not pay attention to keeping the patient in the hospital although acute care was no longer needed. Female patients, non-elective admissions, admissions by general pediatricians or traumatology and weekend stays had significantly higher proportions of inappropriate utilization. Conclusions: A considerable proportion of inappropriate admissions and stays was observed, although it is in the lower range of those observed in other studies in pediatric patients. The most frequent reasons were attributed to an excessively conservative medical practice.