Medically inappropriate inpatient care in West Germany.

The extent of medically unnecessary hospital utilization in West German acute hospitals was measured by a representative study. A random sample of medical records was reviewed and assessed according to appropriateness by specially experienced physicians. This rating method was trained, standardized and evaluated. The study yields a mean length of stay of 13 days with 2.4 days (18.4%) of inappropriate use. Further analyses concern the influence of diagnoses, age, sex, hospital size etc. Prorated to all 461 300 West German acute hospital beds, 85,000 beds or 26.6 million patient days per year are affected by inappropriate use.