Abstract:

Objective To investigate the agreement of appropriateness evaluation protocol (AEP) of admission and hospital days in department of gynecology and department of neurology. Methods The clinical data of 50 patients hospitalized in department of gynecology and 50 patients in department of neurology in Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine were randomly selected, and the appropriateness of admission and hospital days was retrospectively evaluated by two nurses based on AEP. The inter-rater agreement of two nurses and Cohen's Kappa (κ) were calculated, and the agreement of AEP of admission and hospital days was determined. Meanwhile, the concept of “overrides” was introduced to increase the flexibility of AEP. Results After deletion of the incomplete data, 43 medical records from each department entered the statistical analysis. For the agreement of AEP-based judgment towards admission appropriateness, the overall agreement rate was 90.70%, and κ was 0.59. For the inter-rater agreement of AEP-based judgment towards hospital days appropriateness, the overall agreement rate was 77.52%, and κ was 0.54. After introduction of “overrides”, the inter-rater overall agreement rate was 81.65%, and  κ was 0.61. Conclusion Original AEP yields good agreement in assessment of the appropriateness of inpatient services in department of gynecology and department of neurology.

Key words: appropriateness evaluation protocol of admission and hospital days, admission, hospital days, agreement