Appropriateness Evaluation of Hospital Utilization at Ain Shams University Surgical Hospital

Abstract

Nowadays, as hospital services constitute the most expensive item of national health budgets, efficient use demands close attention to length of stay, (Mozes et al, 1987). In a report on the appropriateness of hospital utilization in Manitoba for patients with medical diagnoses, they concluded that 51 % of admissions at the study hospitals were inappropriate and that 67% of the days of stay were unnecessary, (Hunter, 1997). Nour El Din (1998), reported that in a study conducted m Health Insurance Organization Hospitals and a private hospital in Alexandria, the proportion of inappropriate admissions was 24.4% in the general surgery department. Hospital administrators are trying to increase the appropriate use of hospital beds and reduce the inappropriate use .This led to the development of the utilization review (UR) which is a component of the utilization management (UM). Utilization management is the planning, organizing directing and controlling of the health care product in a cost effective manner, while maintaining quality of patient care and contributing to the overall goals of the institution, (Brown, 2000). The purpose of UM and UR is to both identify and resolve problems that cause inappropriate hospital utilization.