The evaluation of screening methods to identify medically unnecessary hospital stay for patients with pneumonia.

Journal Article (Journal Article)

OBJECTIVES: This study compared three methods to screen charts of pneumonia patients for excess days. METHODS: A derivation data set was used to statistically derive a severity measure to predict length of stay for pneumonia patients and to refine a clinical algorithm for identifying excess stay. A validation data set was used to compare three computerized methods to screen for unnecessary hospital days: (1) an observed length of stay greater than a target value; (2) an observed stay greater than predicted for the specific patient; and (3) an algorithm that tested whether there were clinical justifications for the entire hospital stay. RESULTS: The sensitivity and specificity for detecting excess stay for the three methods were (1) 0.48 and 0.85 for the observed stay greater than the target value; (2) 0.56 and 0.73 for observed stay greater than predicted; and (3) 0.83 and 0.85 for the algorithm. CONCLUSIONS: These results suggest that computerized clinical algorithms may provide a useful method to detect unnecessary hospital stay.

Full Text

Duke Authors

Cited Authors

  • Hartz, AJ; Bade, PF; Sigmann, P; Guse, C; Epple, P; Goldberg, KC

Published Date

  • February 1996

Published In

Volume / Issue

  • 8 / 1

Start / End Page

  • 3 - 11

PubMed ID

  • 8680814

International Standard Serial Number (ISSN)

  • 1353-4505

Digital Object Identifier (DOI)

  • 10.1093/intqhc/8.1.3


  • eng

Conference Location

  • England