The Financial Burden of Inappropriate Admissions to Intensive Care Units of Shahid Faghihi and Nemazee Hospitals of Shiraz, Iran, 2014

[摘要] Background:Investigatingtheconditionsandtheappropriatenessofadmissionofpatientsinhospitalsisanimportantissuewhichcanimprovetheefficiencyofhealthcaredelivery.Intensivecareunit(ICU)isimportantduetoapplyingexpensivefinancialsources;therefore,itsefficientapplicationisofgreatpriority.Inthisregard,thecurrentstudyaimedtodeterminethefinancialburdenofinappropriateadmissionsininternalintensivecareunits(IICUs).Methods:Itwasacross-sectionalstudyconductedin2014.Atotalof294patientsadmittedtoIICUsofShahidFaghihiandNemazeehospitalsofShiraz,Iran,in2012wereenrolledintothisretrospectivestudy.Thestudywasconductedintwophases,usingtheguidelinesofAmericancriticalcareassociation(ACCA)andexperts’opiniontoinvestigatethefinancialburdenofinappropriateadmissionsinIICUsoftheabove-mentionedhospitals.Results:Theresultsshowednostatisticallysignificantrelationshipsamonginsurancestatus,insurancetype,age,genderandinappropriateadmissionbyapplyingChi-square.Among294admittedpatientsunderthestudy,theinappropriateadmissionswere11.2%basedontheguidelinesand13.6%basedontheexperts’opinion.Thelevelofagreementoftheguidelinesandexperts’opinionfortheinappropriateadmissionswas0.076basedonKappacoefficient.ThetotalfinancialburdenimposedontheinsuranceagenciesandthepatientsbyinappropriateadmissionswasUS$47867.78basedontheguidelinesandUS$83241.68basedontheexperts’opinion.Conclusions:InappropriateadmissionstoICUsmayimposeadditionalcoststothehealthsystemandthepatientsononehand,anddeprivesotherpatientsfromreceivinghealthservices.Therefore,itiscrucialtoeffectivelyplanfortheapplicationofICUbeds.

[学科分类] 基础医学

[关键词] Financial Burden;Inappropriate Admission;Intensive Care Unit