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Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China
BACKGROUND: The incidence of inappropriate admissions in China has become the shackle of its’ service supply system. This research aims to assess the level of children’s inappropriate admissions to county hospitals in rural China and identify the characteristics and determinants of children’s inappr...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378739/ https://www.ncbi.nlm.nih.gov/pubmed/30777048 http://dx.doi.org/10.1186/s12913-019-3944-1 |
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author | Lei, Shi-han Zhang, Yan Li, Hao-miao Su, Dai Chang, Jing-jing Hu, Xiao-mei Ye, Qing Jiang, Di Chen, Ying-chun |
author_facet | Lei, Shi-han Zhang, Yan Li, Hao-miao Su, Dai Chang, Jing-jing Hu, Xiao-mei Ye, Qing Jiang, Di Chen, Ying-chun |
author_sort | Lei, Shi-han |
collection | PubMed |
description | BACKGROUND: The incidence of inappropriate admissions in China has become the shackle of its’ service supply system. This research aims to assess the level of children’s inappropriate admissions to county hospitals in rural China and identify the characteristics and determinants of children’s inappropriate admissions. METHODS: A retrospective review was conducted on data of children aged 0–14 years. A total of 771 children medical records in four county hospitals was collected by stratified random sampling in Midwestern China and was evaluated through the Rural Appropriateness Evaluation Protocol. A questionnaire survey was conducted among doctors whose names were shown in medical records. Chi-square test was used to analyse the characteristics of inappropriate admissions, and a binary logistic regression model was used to examine the determinants of inappropriate admissions. RESULTS: Inappropriate admissions indicate that patients who could have been treated as outpatients received services as inpatients. The average rate for inappropriate admissions of children in county hospitals was 61.35%. The highest rate of inappropriate admissions was found among children aged 1–5 years (68.42%). Inappropriate admissions mostly occurred in children with respiratory diseases (72.45%), circulatory diseases (72.22%) and certain infectious diseases and parasitic diseases (70.37%). Binary logistic regression analysis showed that county, normal health status, treating department, disease, the length of hospital stay and the doctor’s self-evaluation on the understanding about the degree of the patient’s feelings were determinants for children’s inappropriate admissions. CONCLUSIONS: County hospitals have a high rate of inappropriate admissions of children. The relationship of children’s inappropriate admissions to age distribution and the insurance compensation is affected by disease and hospitalisation expenses, respectively. The determinants of children’s inappropriate admissions are directly related to the weak level of primary care services in the health service system, the initial requirements requested by children’s admission decision makers and the interests among medical institutions and doctors. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-019-3944-1) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6378739 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63787392019-02-28 Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China Lei, Shi-han Zhang, Yan Li, Hao-miao Su, Dai Chang, Jing-jing Hu, Xiao-mei Ye, Qing Jiang, Di Chen, Ying-chun BMC Health Serv Res Research Article BACKGROUND: The incidence of inappropriate admissions in China has become the shackle of its’ service supply system. This research aims to assess the level of children’s inappropriate admissions to county hospitals in rural China and identify the characteristics and determinants of children’s inappropriate admissions. METHODS: A retrospective review was conducted on data of children aged 0–14 years. A total of 771 children medical records in four county hospitals was collected by stratified random sampling in Midwestern China and was evaluated through the Rural Appropriateness Evaluation Protocol. A questionnaire survey was conducted among doctors whose names were shown in medical records. Chi-square test was used to analyse the characteristics of inappropriate admissions, and a binary logistic regression model was used to examine the determinants of inappropriate admissions. RESULTS: Inappropriate admissions indicate that patients who could have been treated as outpatients received services as inpatients. The average rate for inappropriate admissions of children in county hospitals was 61.35%. The highest rate of inappropriate admissions was found among children aged 1–5 years (68.42%). Inappropriate admissions mostly occurred in children with respiratory diseases (72.45%), circulatory diseases (72.22%) and certain infectious diseases and parasitic diseases (70.37%). Binary logistic regression analysis showed that county, normal health status, treating department, disease, the length of hospital stay and the doctor’s self-evaluation on the understanding about the degree of the patient’s feelings were determinants for children’s inappropriate admissions. CONCLUSIONS: County hospitals have a high rate of inappropriate admissions of children. The relationship of children’s inappropriate admissions to age distribution and the insurance compensation is affected by disease and hospitalisation expenses, respectively. The determinants of children’s inappropriate admissions are directly related to the weak level of primary care services in the health service system, the initial requirements requested by children’s admission decision makers and the interests among medical institutions and doctors. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-019-3944-1) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-18 /pmc/articles/PMC6378739/ /pubmed/30777048 http://dx.doi.org/10.1186/s12913-019-3944-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Lei, Shi-han Zhang, Yan Li, Hao-miao Su, Dai Chang, Jing-jing Hu, Xiao-mei Ye, Qing Jiang, Di Chen, Ying-chun Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China |
title | Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China |
title_full | Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China |
title_fullStr | Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China |
title_full_unstemmed | Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China |
title_short | Determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural China |
title_sort | determinants of inappropriate admissions of children to county hospitals: a cross-sectional study from rural china |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378739/ https://www.ncbi.nlm.nih.gov/pubmed/30777048 http://dx.doi.org/10.1186/s12913-019-3944-1 |
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