The use of Appropriateness Evaluation Protocol in otorhinolaryngology patients

Background and objective: Determination of inappropriate hospital use is of increasing importance due to limited resources in health care. The Appropr iateness Evaluation Protocol (AEP) serves as an instrument to identify this inappropriate hospital use. It was designed in the USA in 1981 for use in Internal Medicine and General Surgery and consists of criteria items to ass ess the appropriateness of hospital admissions and days of care. Patients/Methods: The present study aims to examine the practicability of t he AEP in Otorhinolaryngology. The charts of all patients hospitalized in t he ENT Department at that particular day were surveyed on 4 consecutive Wed nesdays. Three reviewers each reviewed 196 charts. Results: The overall level of inappropriate use was 41.5%. Presuming that t he day preoperative to elective surgery was appropriate, the level was 23.1 %. Conclusions: The critical comparison between this result and the actual rea sons for hospital admissions and days of care showed, that the present Germ an version of the AEP is less suitable for use in Otorhinolaryngology. Base d on the experiences with the AEP an AEP adjusted to Otorhinolaryngology (A EP-ENT) is proposed.