Impacto de una intervención de retroinformación y autoevaluación en la reducción de ingresos inadecuados en servicios de Cirugía General Impact of an intervention of feedback and self-assessment in the reduction of inadequate hospital admissions on Surgical Departments

Background: Evaluation of the effectiveness of an intervention on surgical specialists, in the reduction of inadequate hospital admissions. Material and methods: We made an intervention which included educational components, feedback and self evaluation on two Surgical Departments (intervention group, IG) in the province of Alicante, where we evaluated the percentage of inadequate hospital admissions with the Appropriateness Evaluation Protocol before, during and after the intervention. A third service served as a control group (CG). Results: The percentage of inadequate hospital admissions in the IG was reduced significantly from 24.6% in the baseline period to 7.9% during the intervention (a relative reduction of 68%, p < 0.01) and increased to 8.1% after the intervention. The CG did not show any significant differences. The reduction of inadequate hospital admissions was mainly due to a reduction of «premature admissions», from 20% in the baseline period to 3.9% during the intervention (relative reduction of 80%, p < 0.01) and 5% after the intervention. Conclusions: The active feedback on the clinicians of the Surgical Departments regarding their own percentage of unnecessary hospital admissions and stays, supported by educational and a self-assessment components, was effective in order to reduce the percentage of inadequate hospital admissions.