Little is known about the clinical characteristics of hospital patients who do not meet standard utilization review criteria for acute care settings. This study ex amined whether patients with either inappropriate hos pital admissions or days of care were less severely ill on a number of indicators compared to those designated as appropriate by a widely used utilization review instru ment. Using data from a probability sample of 6063 med ical and surgical hospitalizations at 50 Department of Veterans Affairs medical centers, we found strong asso ciations between the appropriateness of admissions and days of care and four indicators of severity of illness. These results suggest that utilization management pro grams and preadmission screening probably successfully screen out less severely ill patients who have less need of hospital-level services.
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