Assessment of appropriateness of hospitalizations in Ukraine: analytical framework, method, and findings

Objectives: This article reviews the applicability of a customized version of the Appropriateness Evaluation Protocol (AEP) to evaluate the magnitude of inappropriate hospitalizations in two regions of Ukraine.

Data and methods: The original AEP was modified to develop a customized tool, which included criteria for the appropriateness of hospitalization and duration of inpatient stay. The customization of the tool followed the Delphi procedure. We randomly selected 381 medical records to test the feasibility and reliability of the method and 800 medical records to evaluate the scope of inappropriate hospitalizations. We used descriptive and analytical statistics, ROC analysis, and Cohen's kappa to check the consistency between the findings of primary reviewers and experts.

Result: We observed high levels of agreement in conclusions of primary reviewers (reference standard) and experts during testing of the reliability and validity of the method. The external validity check showed ...