scholarly journals Modelling the substitutability of community, long-term, and hospital care and their impact on acute hospital length of stay in Ireland

2017 ◽  
Vol 17 (5) ◽  
pp. 185
Author(s):  
Brendan Walsh ◽  
Samantha Smith ◽  
Maev-Ann Wren ◽  
James Eighan
Keyword(s):  
Length Of Stay ◽  
Hospital Care ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay

scholarly journals The independent patient factors that affect length of stay following hip fractures

2018 ◽  
Vol 100 (7) ◽  
pp. 556-562 ◽  
Author(s):  
T Richards ◽  
A Glendenning ◽  
D Benson ◽  
S Alexander ◽  
S Thati
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Patient Factors ◽  
Mobility Status

Introduction Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. Methods A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. Results American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. Conclusions Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.

scholarly journals Age, co-morbidity and poor mobility: no evidence of predicting in-patient death and acute hospital length of stay in the oldest old

QJM ◽  
2011 ◽  
Vol 104 (8) ◽  
pp. 671-679 ◽  
Author(s):  
Y. Pai ◽  
C. Butchart ◽  
C. J. Lunt ◽  
P. Musonda ◽  
N. Gautham ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Oldest Old ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Patient Death ◽  
Co Morbidity

scholarly journals Hospital outreach service: Helping to prevent nursing home placement

1998 ◽  
Vol 21 (4) ◽  
pp. 192 ◽  
Author(s):  
Phillip Bairstow ◽  
Sarah Ashe ◽  
Mary Bairstow
Keyword(s):  
Nursing Home ◽  
Length Of Stay ◽  
Health Service ◽  
Hospital Length ◽  
Nursing Home Placement ◽  
Hospital Length Of Stay ◽  
Advantages And Disadvantages ◽  
Outreach Service ◽  
Home Placement

An outreach service from a post-acute metropolitan teaching hospital delivered anintensive, multidisciplinary and coordinated allied health service, and achieved bothearly hospital discharge and the prevention or delay of nursing home placement. Thisarticle reports on three types of cases which illustrate how the service assisted wardteams, families and patients to determine whether nursing home placement wasessential. For a group of 20 cases, the total reduction in hospital length of stay was556 days, and home accommodation as an alternative to nursing homeaccommodation was achieved for a total of 7505 days. The article outlines a matrixof advantages and disadvantages, both tangible and intangible, of home versusnursing home accommodation. It is suggested that a full costing of this matrix wouldinform debate on the comparative merits of long-term home and nursing homeaccommodation.

scholarly journals Does service heterogeneity have an impact on acute hospital length of stay in stroke? A UK-based multicentre prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024506 ◽  
Author(s):  
Michelle Tørnes ◽  
David McLernon ◽  
Max Bachmann ◽  
Stanley Musgrave ◽  
Elizabeth A Warburton ◽  
...  
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Multiple Linear Regression Model ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Secondary Outcome ◽  
Hospital Level

ObjectivesTo determine whether stroke patients’ acute hospital length of stay (AHLOS) varies between hospitals, over and above case mix differences and to investigate the hospital-level explanatory factors.DesignA multicentre prospective cohort study.SettingEight National Health Service acute hospital trusts within the Anglia Stroke & Heart Clinical Network in the East of England, UK.ParticipantsThe study sample was systematically selected to include all consecutive patients admitted within a month to any of the eight hospitals, diagnosed with stroke by an accredited stroke physician every third month between October 2009 and September 2011.Primary and secondary outcome measuresAHLOS was defined as the number of days between date of hospital admission and discharge or death, whichever came first. We used a multiple linear regression model to investigate the association between hospital (as a fixed-effect) and AHLOS, adjusting for several important patient covariates, such as age, sex, stroke type, modified Rankin Scale score (mRS), comorbidities and inpatient complications. Exploratory data analysis was used to examine the hospital-level characteristics which may contribute to variance between hospitals. These included hospital type, stroke monthly case volume, service provisions (ie, onsite rehabilitation) and staffing levels.ResultsA total of 2233 stroke admissions (52% female, median age (IQR) 79 (70 to 86) years, 83% ischaemic stroke) were included. The overall median AHLOS (IQR) was 9 (4 to 21) days. After adjusting for patient covariates, AHLOS still differed significantly between hospitals (p<0.001). Furthermore, hospitals with the longest adjusted AHLOS’s had predominantly smaller stroke volumes.ConclusionsWe have clearly demonstrated that AHLOS varies between different hospitals, and that the most important patient-level explanatory variables are discharge mRS, dementia and inpatient complications. We highlight the potential importance of stroke volume in influencing these differences but cannot discount the potential effect of unmeasured confounders.

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