الفهرس 
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Abstract
This study was conducted in Menoufia University Hospitals. The study included 350 participants.
Data collection was divided into two phases: first phase: A detailed study of the main major departments in Menoufia University Hospitals: general surgery& internal medicine departments. In addition to two randomly selected ones: chest and urology departments as representatives to medical and surgical departments, respectively. The enrolled patients were subjected to a pre-designed questionnaire that consisted of three parts: socio-demographic data, admission and discharge data and appropriateness evaluation protocol (AEP). AEP is the tool most widely tested and validated in various countries for measuring the appropriateness of hospitalizations and hospital stays. Second phase of data collection: A record analysis was used to assess the pattern of bed utilization in Menoufia University Hospitals during 2016. Medical records from Hospital Statistics Unit were reviewed to highlight the following indicators:-
Average hospital stay (days)= total inpatient days/ no of admissions
Bed turnover rate (person⁄ bed)= no of discharges/ no of beds
Bed occupancy rate (%) = no of bed days used/ no of available bed days
from this study, the following results were obtained:
The percentages of inappropriate hospital admission and stay were 18.3% and 18.6% respectively.
General surgery department had an equal percentage of inappropriate admission and stay (32.8%), and it was the highest rate. On the other hands, all admissions and stay to chest department were appropriate.
Admission to avoid waiting time for investigations was the most common reason of inappropriate admission in different departments. Detailed study of each department separately showed that admission required by the general practitioner (GP) or specialist was the most common reason in internal medicine department (100%), admission to avoid waiting time for investigations was the most common one in general surgery department (47.1%) and premature admission was the most common one in urology department (40%).
Waiting for surgical procedure was the most common reason of inappropriate pre-procedure hospital stay in different departments (64.2%). Half of the participants (50%) didn’t got their surgical procedure on time because they were waiting for investigation results. Internal medicine department was excluded from pre-procedure hospital stay statistical analysis as it was appropriate. On the other hand, the most common reason of inappropriate post-procedure hospital stay in different departments was conservative practice (58.4%). Half of the participants (50%) needed outpatient care instead of hospital stay for conservation.
Regarding logistic regression model of risk factors associated with inappropriate admission and stay; rural residence, living far from hospital ≥10 km, admission for surgical treatment and being admitted for the first time were significant predictors of inappropriate admission. While, female patients, age <50, illiteracy, prolonged LOS and admission for surgical procedure were significant predictors of inappropriate hospital stay.
from record analysis of the calendar year 2016, there was a great variability in bed occupancy rates according to specialty. Some departments were under-utilized as cardiothoracic surgery and forensic& toxicology departments, while cardiology department had the highest bed occupancy rate and bed turnover rate (96.8%) and (149.4 person ⁄ bed) respectively.
Overall bed occupancy rate, overall bed turnover rate and average hospital stay were 76.39%, 67.03 person ⁄ bed and 4.12 days respectively. There was a highly significant difference between medical and surgical departments regarding bed occupancy rate, but other bed utilization rates were non-significantly different among departments.