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Table 5 AEP criteria for county hospitals

From: Effect of inappropriate admissions on hospitalization performance in county hospitals: a cross-sectional study in rural China

A. Medical service intensity

 A1. Need follow-up treatment within 24 h: (1) instruments or other facilities that are only available for hospitalised patients (angiography, visceral biopsy, cardiac catheterisation intervention) and/or (2) invasive diagnostic of central skeletal muscle meat (lumbar puncture, cisterna puncture, ventricular puncture, encephalography)

 A2. Treatment with varying dosages or drugs on a regular basis under direct medical supervision

 A3. Calculation of intake and output volume

 A4. Operation to be conducted on the following day in the operating room, detailed pre-operative consultation or evaluation on the day of admission

 A5. Main surgical incision and drainage nursing

 A6. Quarantined patients

 A7. Bedside electrocardiogram (ECG) monitoring or testing vital signs at least every 2 h

 A8. Stopping (at least once every 8 h) or continuing oxygen inhalation

 A9. Referral of post-operative recovery

B. Disease severity

 B1. Continuous fever > 38.0 °C for more than 5 days

 B2. Acute confusion (coma or adiaphoria)

 B3. Severe anomaly in electrolyte or blood and vigour, showing the following situations: (1) Na < 123 mEq/L or > 156 mEq/L; (2) K < 2.5 mEqt/L or > 6.0 mEq/L; (3) HCO3 < 20 mEq/L or > 36 mEq/L; and (4) arterial blood pH < 7.30 or > 7.45

 B4. Loss of sight or hearing for 48 h

 B5. Loss of activity in any part of the body for 48 h

 B6. Excretion disorder or absence of intestinal peristalsis in the past 24 h

 B7. Active bleeding

 B8. Needing blood transfusion because of bleeding

 B9. Mental disorders caused by non-alcohol dependence

 B10. Viscera removal or surgical wound dehiscence

 B11. Pulse less than 50 or greater than 140 beats per minute

 B12. Abnormal blood pressure: systolic blood pressure < 90 mmHg or > 200 mmHg and/or diastolic blood pressure < 60 mmHg or > 120 mmHg

 B13. Ventricular fibrillation or acute myocardial ischemia shown by electrocardiogram (ECG) report or course log

 B14. Acute hematopathy, severe medium-sized leukopenia, thrombocytopaenia, leukocytosis, erythrocytosis, thrombocytosis or haemolysis-resulted symptoms

 B15. Progressive acute neurological disorders

 B16. Soft tissue injuries affecting basic self-care

 B17. Acute myocardial infarction or cerebrovascular accident (stroke)

 B18. Spinal cord lesions

 B19. Lung infection above 50% or leafy lesions according to X-ray examination

 B20. Hyperemesis or acute pain caused by acute or chronic diseases

  1. The AEP criteria for the county hospital was derived from the research results of a National Natural Science Foundation project undertaken by our research team. (Research on Measurement and Management of Excessive Demand for Inpatient Service of the New Rural Cooperative Medical Scheme, NO. 71073061). It was based on the experience of international AEP criteria, and was combined with the reality of rural China. After several rounds of expert consultation and combined with field research, the AEP criteria for county hospital was accomplished and a monograph (Excessive demand for rural hospitalization service—a study on the measurement and management of inappropriate admission) has been published