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Changwoo Lee 1 Article
Reliability and Validity of the Appropriateness Evaluation Protocol for Public Hospitals in Korea
Clara Lee, Stella Jung-Hyun Kim, Changwoo Lee, Euichul Shin
J Prev Med Public Health. 2019;52(5):316-322.   Published online September 12, 2019
DOI: https://doi.org/10.3961/jpmph.19.125
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  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea.
Methods
In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared.
Results
The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively.
Conclusions
Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.
Summary
Korean summary
이 연구는 우리나라 공공병원을 대상으로 Appropriateness Evaluation Protocol(AEP) 도구를 적용가능성을 검토하기 위해 실시되었다. 우리나라의 지역공공병원 입원자료(2016년 5월 기준)를 층화무작위추출을 통해 1,500건을 추출하였으며, 이중 37개 병원의 560건에 대해 입원적정성을 분석하였다. 의무기록사 2인은 AEP 도구를 이용하여 입원적정성을 각각 검토하였고, 의사 1인은 전문가적 판단을 기준으로 검토하였다. AEP 도구의 적용가능성을 판단하기 위해 의무기록사간 그리고 의무기록사-의사간 일치율을 산출하였다. 의무기록사간 일치율은 거의 완벽한 수준으로 나타났고, 의무기록사-의사간은 중등도의 일치율을 보였다. 민감도, 특이도는 각각 0.86 그리고 0.56이었다. 이러한 결과는 AEP 도구가 우리나라 공공병원의 입원적정성을 평가하기 위한 일관적이고 정확한 도구임을 제시한다.

Citations

Citations to this article as recorded by  
  • Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study
    Diego San Jose-Saras, Jorge Vicente-Guijarro, Paulo Sousa, Paloma Moreno-Nunez, Jesús María Aranaz-Andres, Cristina Díaz-Agero Pérez, Miguel Ignacio Cuchi Alfaro, Juan Manuel Ramos López, Mercedes García Haro, Abelardo Claudio Fernández Chávez, Cornelia B
    BMC Medicine.2023;[Epub]     CrossRef
  • Inappropriate Hospital Admission According to Patient Intrinsic Risk Factors: an Epidemiological Approach
    D. San Jose-Saras, J. Vicente-Guijarro, P. Sousa, P. Moreno-Nunez, M. Espejo-Mambié, J. M. Aranaz-Andres
    Journal of General Internal Medicine.2023; 38(7): 1655.     CrossRef
  • Strategies to improve the flow of admissions and hospital stays: a Delphi study of an adaptation of the Appropriateness Evaluation Protocol (AEP)
    A. Morillo-Rodríguez, S. Alonso-Fernández, J.M. Mòdol Deltell, B. Soldevila Madorell, Ll. Benito-Aracil, D. Parés
    Revista Clínica Española (English Edition).2023; 223(5): 270.     CrossRef
  • Estrategias para mejorar el flujo de ingresos y estancias hospitalarias: adaptación del cuestionario Appropriateness Evaluation Protocol (AEP): estudio Delphi
    A. Morillo-Rodríguez, S. Alonso-Fernández, J.M. Mòdol Deltell, B. Soldevila Madorell, Ll. Benito-Aracil, D. Parés
    Revista Clínica Española.2023; 223(5): 270.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health