Inappropriate use of hospital beds: a case study of university hospitals in Turkey.

The purpose of this study is to estimate the degree of Inappropriate Patient Days (IPDs) in a teaching hospital in Turkey using the Appropriateness Evaluation Protocol (AEP) criteria. One day was randomly chosen in 1995 for review and a second day was chosen close to the randomly selected day to indicate possible differences between a weekday and a weekend. Total hospital days reviewed were 221 with 114 days on Sunday and the remaining 107 days on a Tuesday. The evaluation indicates that more than 22 percent of patient days were inappropriate in the university hospital in Turkey. Multiple logistic regression equations were estimated to identify the determinants of IPDs. The results imply that age and sex of patient, clinical diagnosis at admission and type of health insurance coverage affect IPDs significantly. However, most of the IPDs occurred during the initial few days of hospital stay. Therefore, to improve the productivity of hospital resources, the gap between the admission date and the date of medical or surgical interventions should be reduced.