[Analysis of the appropriateness of hospitalizations in Monastir, Tunisia]

We aimed to measure the extent of inappropriate hospital admissions and to identify factors associated with inappropriate hospital use. A descriptive study was carried out on a r and omized sample of 411 hospitalizations in 3 regional hospitals. The appropriateness of admissions was assessed using the Appropriateness Evaluation Protocol [AEP]. We found 21% [95% CI: 17%-25%] of the admissions were avoidable according to the AEP. Inappropriate admissions were associated with the hospital [P = 0.005], patient age [P = 0.003], length of stay and diagnosis [P < 0.001]. The most frequent reasons for appropriate admissions were parenteral therapy, an acute or progressive sensory motor circulatory or respiratory condition sufficient to incapacitate the patient and severe electrolyte or blood gas abnormality. Our study highlights the need to improve hospital management and to develop alternatives to hospitalization

Prescribing rationality and availability of antimalarial drugs in Hajjah, Yemen

This study in 3 districts of Hajjah governorate, Yemen, used WHO core indicators to investigate irrational prescribing of antimalarial drugs in public and private health facilities. Laboratory diagnosis rates were low in public facilities [21.2% of encounters]. Informal prescriptions were issued in > 70% of encounters [public and private]. Important patient and drug information was missing from many prescriptions. Both public and private facilities had high rates of prescribing multiple drugs [mean 3.0 and 4.0 respectively per encounter, maximum 11], brand-name drugs [32.9% and 64.2%] and injections [17.2% and 33.5%]. The total number of antimalarial drugs registered in the country was found to be 98, with 52 different formulations and strengths of chloroquine. Efforts should be made to promote rational prescribing of antimalarials