The Appropriateness Evaluation Protocol (AEP) was developed as an assessment tool to help decide if the hospitalization of an adult patient is appropriate. The authors are from Boston University.


Design objectives:

(1) limited number of items, so easy for reviewer to learn and apply

(2) good inter-observer agreement


Items evaluated:

(1) medical services: 11 items

(2) nursing and ancillary services : 7 items

(3) patient's condition: 1 item occurring within 24 hours of the day reviewed, 7 items occurring within 48 hours of the day reviewed, and 1 item occurring within 14 days



• A hospital admission was considered appropriate if one or more of the above criteria was present.

• A hospital admission was considered inappropriate if none of the above criteria were present.

• The evaluator may over-ride the criteria for either appropriate or inappropriate hospitalization.



• Health care has become more aggressive since the article was published. Several items listed above would now be considered appropriate for outpatient or home care.

• This should be viewed as a screen for possible inappropriate hospital care that is sensitive but which may not be specific. A case that fails to meet any of these criteria should be reviewed more closely for an explanation.


To read more or access our algorithms and calculators, please log in or register.