Pediatric Appropriate Evaluation Protocol for India (PAEP-India): Tool for Assessing Appropriateness of Pediatric Hospitalization.

Autor: Das MK; The INCLEN Trust International, Okhla Industrial Area, Phase I, New Delhi, India., Arora NK; The INCLEN Trust International, Okhla Industrial Area, Phase I, New Delhi, India. Correspondence to: Dr Narendra Kumar Arora, Executive Director, The INCLEN Trust International, F1/5, Okhla Industrial Area, Phase 1, New Delhi 110 020, India. nkarora@inclentrust.org., Poluru R; The INCLEN Trust International, Okhla Industrial Area, Phase I, New Delhi, India., Seth A; Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India., Aggarwal A; Department of Pediatrics, University College of Medical Sciences, New Delhi, India., Dubey AP; Department of Pediatrics, Maulana Azad Medical College, New Delhi, India., Goyal PC; Department of Pediatrics, North DMC Medical College and Hindu Rao Hospital, New Delhi, India., Gathwala G; Department of Pediatrics, Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India., Malik A; Department of Pediatrics, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, UP, India., Goel AK; Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India., Chakravarty A; Department of Pediatrics, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India., Arya S; Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India., Upadhyay A; Department of Pediatrics, LLRM Medical College Meerut, Uttar Pradesh, India., Gupta M; Department of Pediatrics, WHO Country office India., Mathew T; Department of Pediatrics, Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India., Pillai RK; Department of Pediatrics, Government Medical College, Thiruvananthapuram, Kerala, India., Mathai J; Department of Pediatrics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India., Manivasagan S; Department of Pediatrics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India., Ramesh S; Department of Pediatrics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India., Aggarwal MK; Ministry of Health and Family Welfare, Government of India, New Delhi, India., Maure CG; World Health Organization, Geneva, Switzerland., Zuber PL; World Health Organization, Geneva, Switzerland.
Jazyk: angličtina
Zdroj: Indian pediatrics [Indian Pediatr] 2018 Dec 15; Vol. 55 (12), pp. 1041-1045.
Abstrakt: Objective: To develop and assess Pediatric Appropriateness Evaluation Protocol for India (PAEP-India) for inter-rater reliability and appropriateness of hospitalization.
Design: Cross-sectional study.
Setting: The available PAEP tools were reviewed and adapted for Indian context by ten experienced pediatricians following semi-Delphi process. Two PAEP-India tools; newborn (≤28 days) and children (>28 days-18 years) were developed. These PAEP-India tools were applied to cases to assess appropriateness of admission and inter-rater reliability between assessors.
Participants: Two sets of case records were used: (i) 274 cases from five medical colleges in Delhi-NCR [≤28 days (n=51); >28 days to 18 years (n=223)]; (ii) 622 infants who were hospitalized in 146 health facilities and were part of a cohort (n= 30688) from two southern Indian states.
Interventions: Each case-record was evaluated by two pediatricians in a blinded manner using the appropriate PAEP-India tools, and 'admission criteria' were categorized as appropriate, inappropriate or indeterminate.
Outcome Measures: The proportion of appropriate hospitalizations and inter-rater reliability between assessors (using kappa statistic) were estimated for the cases.
Results: 97.8% hospitalized cases from medical colleges were labelled as appropriate by both reviewers with inter-rater agreement of 98.9% (k=0.66). In the southerm Indian set of infants, both reviewers labelled 80.5% admissions as appropriate with inter-rater agreement of 96.1% (k= 0.89).
Conclusions: PAEP-India (newborn and child) tools are simple, objective and applicable in diverse settings and highly reliable. These tools can potentially be used for deciding admission appropriateness and hospital stay and may be evaluated later for usefulness for cost reimbursements for insurance proposes.
Databáze: MEDLINE
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