Comparing two different techniques to assess the appropriateness of admissions provided in the emergency room of a pediatric hospital

Abstract

Two different techniques aimed to assess the appropriateness of hospital utilisation were used to study the same sample of clinical records of admissions provided during 2001 by the emergency room of a pediatric sicilian hospital. The first technique estimated the '"high risk of inappropriateness" DRGs prevalence, according to the Decreto del Presidente del Consiglio dei Ministri of 29 Novembre 2001, and the second was the pediatric version of the Appropriateness Evaluation Protocol (AEP), based on clinical characteristics of patients and complexity of assistance provided. The comparison of results did not show any agreement between the two techniques (kappa= 0,031, C. I. 95%: from -0,001 to +0,062). In a paediatric emergency room AEP criteria cannot be used as clinical guidelines aimed to reduce the prevalence of "high risk of inappropriateness" DRGs.