Development of the paediatric appropriateness evaluation protocol for use in the United Kingdom

Abstract

Background. This paper describes a study to develop and test an instrument to measure the level of appropriate admissions and days of care in the paediatric hospital population. Methods. The American version of the Paediatric Appropriateness Evaluation Protocol (PAEP) was modified by the consensus views of a panel of paediatricians and general practitioners. Reliability was tested in a pilot study in a random sample of 47 admissions from two district general hospitals. Results. The agreement beyond chance for the raters using the PAEP for admission criteria was excellent (κ = 0.848). It was poor (κ = 0.345) for clinicians using subjective judgement. The agreement beyond chance for the day of care criteria was good (κ = 0.54). Trained reviewers achieved much higher reliability using the PAEP. Conclusion. The modified PAEP achieved high reliability and was judged acceptable by clinicians to retrospectively assess the appropriateness of admissions in the UK setting.