[Inappropriateness of Hospital Days and Causes of Failure in a Gastroenterology and Internal Medicine Ward]

Objectives: To analyse patients' features linked to hospital inappropriateness and to highlight causes of inappropriate days in a Gastroenterology and Internal Medicine ward of a teaching hospital.

Methods: Appropriateness of patients' hospital days (2 months activity) was assessed using the French version of criteria of the Appropriateness Evaluation Protocol. Reasons of inappropriate hospital days were identified through a questionnaire based on patients' need.

Results: Two hundred and twenty patients were studied. Among the 2151 hospital days assessed, 880 (41%) were inappropriate. Two different groups of inappropriate stays were brought up. In the first group, the inappropriate period duration was short (<=5 days) and patients were not different from those of the appropriate group. In the second group, the inappropriate period duration was long ( > 5 days) and 710 days (33%) were inappropriate. Patients were elderly, lived alone and their disease did not concern the gastrointestinal tract. During inappropriate days, they expected access to less technical facilities than the short stay medical ward.

Conclusion: The socio-demographic and medical features of the patients from the long duration inappropriateness group should help to limit inappropriate hospital days: a significant economic and organizational stake for patients, hospital and public interest.