Appropriateness of Hospital Admission and Length of Stay in the Pediatric Department of a Tertiary Care Hospital in West Bengal

Abstract

Abstract Background: Appropriateness of admissions and inpatient length of stay (LOS) are important factors controlling health-care expenditure. The current study was conducted to assess the proportion of appropriate admissions among 29-day to 12-year--old aged patients admitted to pediatric wards of a tertiary health-care center in one month and evaluate inappropriate LOS among them. Materials and Methods: An observational longitudinal study was carried out for two months among patients admitted to the pediatric inpatient department using Pediatric Appropriateness Evaluation Protocol (PAEP)-II tool. All patients admitted to the institution during the study period were included in the study. Results: Among 495 children, 438 (88.5%) were appropriately admitted. Inappropriate admission was mostly found in children aged 1 to 5 years (29, 16.6%), those who lived >5 km from the hospital (45, 15.2%), and those who presented with other systemic illnesses (13, 31.7%). Among the appropriately admitted children, 333 (76%) met the criteria of appropriate LOS during their hospital stays. Multivariable logistic regression showed that the age of the children (AOR = 0.99; 95% CI = 0.98, 0.99), age-appropriate feeding (AOR = 2.12;95% CI = 1.30,3.47), and hematological disorder (AOR = 0.16; 95% CI = 0.05, 0.52) were found to be associated with the children being kept at the hospital inappropriately. Conclusions: The current study observed a high proportion of appropriate admission in children. However, a higher proportion of inappropriate LOS among them was seen. The younger age group, age-appropriate feeding, and type of illness were found as the primary predictors for inappropriate LOS.