Evaluation of appropriate hospital stay in patients with atherosclerosis without complication (DRG 133).

OBJECTIVE: this study evaluates the appropriateness of the clinical activities performed during hospitalization of patients with atherosclerosis without complications (Disease-related Group - DRG 133 in the Italian National Health System), at the Policlinico Universitario Federico II, Naples. DESIGN AND SETTING: coded criteria PRUO - (Protocol for the revision of hospital use) have been used in order to quantify the appropriateness of 94 randomly selected clinical reports for 2001 and 2002. Two independent examiners have evaluated clinical reports, and a supervisor has decided upon the disagreements (majority rule). Appropriateness was rated by tertiles of age and hospital-stay length. RESULTS: global appropriateness was 68%, and increased 93% when it was related to admission days and 64% when was related to the duration of the hospital-stay. Appropriateness of the use of hospital for DRG 133 diagnosis was more frequent for patients older than 70 years and for short duration of hospital stay. Logistic regression has confirmed the trends, indicating a robust statistical significance for the duration of hospital stay but not for age.