scholarly journals Description of an early discharge post-acute care program: length of hospital stay, patient and carer needs and cost

2002 ◽  
Vol 25 (2) ◽  
pp. 78 ◽  
Author(s):  
Billie Bonevski ◽  
Chris Doran ◽  
Carolyn Bailey ◽  
Julia Lowe

The objective of the project was to evaluate a pilot Post Acute Community Care (PACC) program for orthopaedicpatients. A series of cross-sectional surveys elicited responses of patient and home carer needs and GP and hospital staff acceptability while a cost-minimisation analysis compared the average cost of the PACC program with general orthopaedic hospital care. Patients were classified according to Australian National Diagnosis Related Groups (DRGs). Average length of hospital stay in 1998/99 for PACC patients was 7.7 days compared to 12.3 for generalorthopaedic patients. Only 3% of patients had an unplanned readmission to hospital. Patients and carers expressed a number of unmet needs. This study confirms the popularity of early discharge schemes with patients, and provides little evidence of adverse health outcomes or that the burden of care is shifted to carers in a way that is unacceptable for this older population.

2019 ◽  
Vol 53 ◽  
pp. 65
Author(s):  
Samire Lopes Pereira ◽  
Thales Philipe Rodrigues da Silva ◽  
Alexandra Dias Moreira ◽  
Taiane Gonçalves Novaes ◽  
Milene Cristine Pessoa ◽  
...  

OBJECTIVE: To evaluate whether age group, complications or comorbidities are associated with the length of hospitalization of women undergoing cesarean section. METHODS: A cross-sectional study was carried out between June 2012 and July 2017, with 64,437 women undergoing cesarean section and who did not acquire conditions during their hospital stay. Hospital discharge data were collected from national health institutions, using the Diagnosis-Related Groups system (DRG Brasil). The DRG referring to cesarean section with additional complications or comorbidities (DRG 765) and cesarean section without complications or associated comorbidities (DRG 766) were included in the initial diagnosis. The influence of age group and comorbidities or complications present at admission on the length of hospital stay was assessed based on the means of the analysis of variance. The size of the effect was verified by Cohen’s D, which allows evaluating clinical relevance. The criticality levels were identified using the Duncan test. RESULTS: The longest length of hospital stay was observed in the age group from 15 to 17 years old and among those aged 45 years old or more. The hospital stay of women with complications or comorbidities at the time of admission was also longer. Moreover, it was noted that the increase in criticality level was associated with an increase in the mean length of hospital stay. CONCLUSIONS: The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.


1996 ◽  
Vol 19 (4) ◽  
pp. 20 ◽  
Author(s):  
David I Ben-Tovim ◽  
Rob Elzinga ◽  
Phillip Burgess

The mental health and substance abuse components of AN-DRG 3 were examinedusing data from all inpatient separations in two Australian States over a two-yearperiod. Assignment to a mental health or a substance abuse diagnosis related group(DRG) predicted about 20- per cent of the variability in average length of stay ofpatients treated for such conditions. Assignment to a substance abuse DRG was amuch less robust predictor of length of hospital stay than assignment to a mental healthDRG. There was little variation between years or States. Day-only intent patientswere excluded, as were long-stay outliers identified using an inter-quartile rangetrimming process. Psychiatric DRGs are similar to a number of other non-surgicallyfocused diagnosis related groups in their capacity to predict length of hospital stay. Theyare likely to remain an important component of casemix classification systems.


2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Thales Philipe Rodrigues da Silva ◽  
Bruna Luiza Soares Pinheiro ◽  
Karolina Yukari Kitagawa ◽  
Renato Camargo Couto ◽  
Tânia Moreira Grillo Pedrosa ◽  
...  

ABSTRACT Objectives: to analyze the relationship between maternal age and the source of healthcare payment with mode of delivery in public and private national hospitals between the years 2012 to 2017, and the length of hospital stay. Methods: cross-sectional study of 91,894 women who had children in public and private hospitals between 2012 and 2017. Data were collected from the Diagnosis-Related Groups Brazil system and a comparative analysis was performed between patients in public care and those in supplementary healthcare. Results: in public care, the majority were vaginal deliveries and the reverse occurred in supplementary health. The proportion of cesarean sections was higher in the age group 31 to 40 years old in both services. The hospital stay was longer among women who underwent a cesarean section. Conclusions: high maternal age and the source of healthcare payment influence the mode of delivery, which interfere with the length of hospital stay.


2017 ◽  
Vol 11 (12) ◽  
pp. 4938
Author(s):  
Camilla Christina Rodrigues ◽  
Rita de Cássia Helú Mendonça Ribeiro ◽  
Claudia Bernardi Cesarino ◽  
Daniela Comelis Bertolin ◽  
Renato Mendonça Ribeiro ◽  
...  

RESUMOObjetivo: investigar as causas de internação dos idosos hospitalizados, o perfil demográfico, o perfil clínico e o desfecho. Método: estudo quantitativo, transversal de análise de 14.892 prontuários eletrônicos, no período de 12 meses. Foi realizada uma análise descritiva das variáveis de caracterização amostral e aplicação do teste associativo pela estatística qui-quadrado. Resultados: a maioria dos pacientes avaliados era do sexo masculino, com grau de instrução fundamental, com companheiro, do lar, brancos, católicos e com doenças cardiovasculares, seguidas de neoplasias e doenças gastrointestinais em ambos os sexos.  A idade dos pacientes apresentou média de 72,1 anos e a média da permanência hospitalar foi de 5,9 dias. Houve associação significativa entre as doenças diagnosticadas, o sexo (p <0,001) e a etnia (p = 0,023) dos pacientes. O desfecho mais comum foi a alta dos pacientes. Conclusão: as doenças crônicas foram as principais causas de hospitalização dos idosos, acarretando mais tempo na hospitalização. A investigação destes fatores fornece subsídios para identificação dos problemas e realizar melhores ações de enfermagem. Descritores: Idoso; Hospitalização; Evolução Clínica.ABSTRACT Objective: to investigate the causes of older adult hospitalizations, demographic and clinical profiles, and patient outcome. Method: quantitative cross-sectional study conducted with 14,892 electronic medical records during 12 months. We carried out a descriptive analysis of the variables of the sample characterization, and an associative test using chi-square statistics. Results: most patients assessed were male, had primary education, lived with a partner, were white and Catholics, and had cardiovascular diseases, followed by neoplasms and gastrointestinal diseases in both sexes. The average age of the patients was 72.1 years, and the average length of hospital stay was 5.9 days. There was a significant association between diagnosed diseases, sex (p <0.001), and ethnicity (p = 0.023) of the patients. The most common outcome was hospital discharge. Conclusion: chronic diseases were the main causes of older adult hospitalizations and led to increased length of hospital stay. The assessment of these factors provides subsidies for identifying problems and performing best nursing interventions. Descriptors: Older Adult; Hospitalization; Clinical Evolution.RESUMEN Objetivo: investigar las causas de hospitalización de adultos mayores, perfil demográfico, perfil clínico y desenlaces. Método: estudio cuantitativo transversal con análisis de 14.892 registros médicos electrónicos de un período de 12 meses. Se realizó un análisis descriptivo de las variables de caracterización de la muestra y se aplicó la prueba chi-cuadrado. Resultados: la mayoría de los pacientes evaluados eran hombres, con educación primaria, vivían en pareja, eran blancos, católicos y tenían enfermedades cardiovasculares, seguidas de neoplasias y enfermedades gastrointestinales en ambos sexos. El promedio de edad de los pacientes fue de 72,1 años y de la estancia hospitalaria fue de 5,9 días. Hubo una asociación significativa entre enfermedades diagnosticadas, sexo (p <0.001) y etnia (p = 0.023) de los pacientes. El resultado más común fue el alta hospitalaria. Conclusión: las enfermedades crónicas fueron las principales causas de hospitalización de los adultos mayores, llevando a un tiempo más prolongado de internación. La investigación de estos factores proporciona subsidios para identificación de problemas y realizar mejores intervenciones de enfermería. Descritores: Adulto Mayor; Hospitalización; Evolución Clínica.


Author(s):  
Moslem Heydari pur ◽  
MohammadMehdi Bahri ◽  
Ebrahim SHeykhi

Introduction: Burn injuries are among the most important  causes of disability and medical problems in the world. Weakness and inability of the burn is greater than the pain of the burn. Methods: This is a cross-sectional study-analysis in which the case of 126 patients admitted to the Shohada Mehrab Hospital, affiliated to the Shahid Sadoughi University of Medical Sciences in Yazd during the first six months of 2019, has been reviewed. Data were collected in a checklist designed by the researcher, and demographic variables and using the chi-square test, mean comparison, and  using descriptive and analytical statistics and linear regression in the SPSS V.24 software was analyzed (p>0/05).  Results: The findings of this study stated that  73.8% (93people) of patients were male and 26.2% (33 people) were female. 67.5% (85 people) were burned with thermal flames (p>0/019) and 13.5% (17 people) with boiling water (p>0/44). 77% (97people) of home accidents, 22% (28people) occurred at work, and 1% at other places (farm, car, etc.). 57% of these patients were 20% and 31% between 21 -40 percent burns, burns, 22% between 41-60 percent burns and burns 11% between 61 -80 percent and 5 percent are between 81-100 percent burned.This study results showed that the main cause of burns is fire (67/5%). Conclusion: The results of this study showed that most burns are among men, and about 70% of deaths are among men. The average length of hospital stay was 12 days, 22 patients died, and the fatality rate was 17.5%. This study showed that 67.5 % of burns were of the thermal type and hot water and hot liquids were the next cause of burns (13.5 %). Effective factors are fatality, patient age, and total body surface area (TBSA). 77% of burns occurred at home, 22% at work, and 1% at other places (farm, car, etc.). High incidence of burns and the loss of active community force will result in cost and disability. Treatment of burns requires a long hospital stay, which in addition to the high cost, can cause mental and psychological injuries to the patient.


Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.


2021 ◽  
Vol 9 ◽  
pp. 205031212198963
Author(s):  
Artit Sangkakam ◽  
Pasin Hemachudha ◽  
Abhinbhen W Saraya ◽  
Benjamard Thaweethee-Sukjai ◽  
Thaniwan Cheun-Arom ◽  
...  

Introduction: Influenza virus favours the respiratory tract as its primary site of host entry and replication, and it is transmitted mainly via respiratory secretions. Nasopharyngeal swab is the gold standard specimen type for influenza detection, but several studies have also suggested that the virus replicates in the human gastrointestinal tract. Methods: A retrospective study was conducted on all patients positive for influenza virus and initially recruited as part of the PREDICT project from 2017 to 2018. The objectives of the study were to investigate whether rectal swab could aid in improving influenza detection, and if there was any correlation between gastrointestinal disturbances and severity of infection, using length of hospital stay as an indicator of severity. Results: Of the 51 influenza-positive patients, 12 had detectable influenza virus in their rectal swab. Among these 12 rectal swab positive patients, influenza virus was not detected in the nasopharyngeal swab of three of them. Gastrointestinal symptoms were observed for 28.2% patients with a negative rectal swab negative and 25.0% patients with a positive rectal swab. Average length of hospital stay was 4.2 days for rectal swab positive group and 3.7 days for rectal swab negative group. This difference was not statistically significant (p = 0.288). Conclusions: There is no correlation between influenza virus detection in rectal swab and gastrointestinal disturbances or disease severity, and there is currently insufficient evidence to support replicative ability in the gastrointestinal tract.


2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 251-255 ◽  
Author(s):  
Y. Hashimoto ◽  
T. Terasaki ◽  
T. Yonehara ◽  
M. Tokunaga ◽  
T. Hirano ◽  
...  

Stroke patients tend to stay longer in one hospital compared to patients with other neurological disease. After the introduction of 3 types of critical pathway dedicated for various severity of acute ischemic stroke in 1995, the average length of in-hospital days declined from 30.0 days (1993) to 15.3 days (1998), ie 49% reduction. This reduction was achieved by the use of critical pathway and the hospital-hospital cooperation.


Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 261-261
Author(s):  
Clark C Chen ◽  
Robert Rennert ◽  
Usman Khan ◽  
Stephen B Tatter ◽  
Melvin Field ◽  
...  

Abstract INTRODUCTION We examined the procedural safety and length of hospital stay for patients who underwent stereotactic laser ablation (SLA). METHODS Patients undergoing stereotactic laser ablation were prospectively enrolled in the Laser Ablation of Abnormal Neurological Tissue using Robotic Neuroblate System (LAANTERN) registry. Data from the first 100 enrolled patients are presented. RESULTS >The demographic of the patient cohort consisted of 58% females and 42% males. The mean age and KPS of the cohort were 51 (±17) years and 83 (±15), respectively. 87% of the SLA-treated patients had undergone prior surgical or radiation treatment. In terms of indications, 84% of the SLAs were performed as treatment for brain tumor and 16% were performed as treatment for epilepsy. In terms of the procedure, 79% of the SLA patients underwent treatment of a single lesion. In 72% of the SLA treated patients, >90% of the target lesion was ablated. The average procedural time was 188.2 minutes (range: 48–368 minutes). The average blood loss per procedure was 17.7 cc (range: 0–300cc). In terms of hospitalization, the average length of Intensive Care stay was 38.1 hours (range 0335). The number of hours post-procedure before patient discharge was 61.1 hours (range 6–612). 85% of the patients were discharged home. There were 15 adverse events at the one-month follow-up (12%), with two events definitively related to the procedure (2%), including one patient with post-operative intraventricular hemorrhage and another with post-procedural gait compromise. CONCLUSION SLA is a minimally invasive procedure with favorable profile in terms of safety and hospital length of stay.


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