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Indian Pediatrics

, Volume 55, Issue 12, pp 1041–1045 | Cite as

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

  • Manoja Kumar DasEmail author
  • Narendra Kumar Arora
  • Ramesh Poluru
  • Anju Seth
  • Anju Aggarwal
  • Anand Prakash Dubey
  • Pc Goyal
  • Geeta Gathwala
  • Ashraf Malik
  • Anil Kumar Goel
  • Aparna Chakravarty
  • Sugandha Arya
  • Amit Upadhyay
  • Madhur Gupta
  • Thomas Mathew
  • Rajamohanan K Pillai
  • John Mathai
  • Sivamani Manivasagan
  • S Ramesh
  • Mahesh Kumar Aggarwal
  • Chsirtine G Maure
  • Patrick Lf Zuber
Research Paper
  • 8 Downloads

Abstract

Objectives

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 PAEPIndia tools, and ‘admission criteria’ were categorized as appropriate, inappropriate or indeterminate.

Main 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.

Keywords

Bed use Cost Hospital stay In-patient Utilization 

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Copyright information

© Indian Academy of Pediatrics 2018

Authors and Affiliations

  • Manoja Kumar Das
    • 1
    • 18
    Email author
  • Narendra Kumar Arora
    • 1
  • Ramesh Poluru
    • 1
  • Anju Seth
    • 2
  • Anju Aggarwal
    • 3
  • Anand Prakash Dubey
    • 4
  • Pc Goyal
    • 5
  • Geeta Gathwala
    • 6
  • Ashraf Malik
    • 7
  • Anil Kumar Goel
    • 8
  • Aparna Chakravarty
    • 9
  • Sugandha Arya
    • 10
  • Amit Upadhyay
    • 11
  • Madhur Gupta
    • 12
  • Thomas Mathew
    • 13
  • Rajamohanan K Pillai
    • 14
  • John Mathai
    • 15
  • Sivamani Manivasagan
    • 15
  • S Ramesh
    • 15
  • Mahesh Kumar Aggarwal
    • 16
  • Chsirtine G Maure
    • 17
  • Patrick Lf Zuber
    • 17
  1. 1.The INCLEN Trust International, Okhla Industrial Area, Phase I, New DelhiDepartments of PediatricsNew DelhiIndia
  2. 2.Lady Hardinge Medical CollegeNew DelhiIndia
  3. 3.University College of Medical SciencesNew DelhiIndia
  4. 4.Maulana Azad Medical CollegeNew DelhiIndia
  5. 5.North DMC Medical College and Hindu Rao HospitalNew DelhiIndia
  6. 6.Pt BD Sharma Postgraduate Institute of Medical Sciences, RohtakHaryanaIndia
  7. 7.Jawahar Lal Nehru Medical College, Aligarh Muslim UniversityAligarhIndia
  8. 8.All India Institute of Medical SciencesRaipurIndia
  9. 9.Hamdard Institute of Medical Sciences and ResearchJamia HamdardNew DelhiIndia
  10. 10.Vardhman Mahavir Medical College and Safdarjang HospitalNew DelhiIndia
  11. 11.LLRM Medical College MeerutUttar PradeshIndia
  12. 12.WHO Country office IndiaNew DelhiIndia
  13. 13.Community Medicine, Government Medical CollegeThiruvananthapuramKeralaIndia
  14. 14.Government Medical CollegeThiruvananthapuramKeralaIndia
  15. 15.PSG Institute of Medical Sciences and Research, CoimbatoreTamil NaduIndia
  16. 16.Ministry of Health and Family WelfareGovernment of IndiaNew DelhiIndia
  17. 17.World Health OrganizationGeneva, SwitzerlandIndia
  18. 18.The INCLEN Trust InternationalNew DelhiIndia

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