RESUMO
BACKGROUND: There is wide-spread consensus that a part of the use of hospital resources is inadequate in the sense that the patients receive services that do not provide them with any significant benefits, or that could be more beneficial, or less costly, with a lower care standard. The main aim of this work is to determine the percentage of inadequate admissions and stays in hospital for the four most frequent Diagnosis-Related Groups (DRGs) in a maternity-children's hospital through the retrospective application of the paediatric version of the Adequacy Evaluation Protocol (AEP). METHOD: It was a retrospective study in which 353 out of the 361 medical records that made up the covered population were analysed. Chi-square and linear trend were the statistical analysis methods used. A variance analysis and the Scheffé multiple comparison test were applied to the average values obtained. RESULTS: The admissions were judged to be adequate in 284 (80.5%) of the cases and inadequate in 69 (19.5%). Of the stays in hospital, 76% were deemed to be appropriate and 24% inappropriate. In DRG 030 (stupor and trauma-related coma, coma < 1 hour, age 0-17), a direct relation can be found between the length of the stay in hospital and the inappropriate use of hospitalisation. CONCLUSIONS: The results of this study show that a substantial proportion of the use of the hospital is inappropriate and that, particularly in DRG 030, this use is probably handled in an overly conservative way.