Effects of the Limited English Proficiency of Parents on Hospital Length of Stay and Home Health Care Referral for Their Home Health Care–Eligible Children With Infections

Approximately one in five households in the United States speaks a language other than English at home. This exploratory, descriptive study sought to examine language-concordant visit patterns in an urban home health care agency serving a diverse and multilingual population. Patient care record data combined with administrative data facilitated the exploratory work. In a 2-year period, results showed that among the 238,513 visits with 18,132 limited English proficiency patients, only 20% of visits were language concordant. The study suggests that home health care services may not be meeting the demand for language services, but more research is needed to determine the right “dose” of bilingual home care visits to optimize home care outcomes and establish a standard for care.

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Fast Track Management of Cholecystitis with Same Day Surgery Reduces Hospital Length of Stay and Health Care Costs

Journal of Surgical Research ◽

10.1016/j.jss.2013.11.585 ◽

2014 ◽

Vol 186 (2) ◽

pp. 608-609

Author(s):

P.R. Fillmore ◽

B. Armstrong ◽

M. Johnson ◽

S. Tsuda ◽

T. Browder ◽

...

Keyword(s):

Health Care ◽

Length Of Stay ◽

Health Care Costs ◽

Fast Track ◽

Day Surgery ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Track Management ◽

Care Costs

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Differences in Transitional Care Provided to Mexican American and Non-Hispanic White Older Adults

Journal of Transcultural Nursing ◽

10.1177/1043659615613420 ◽

2016 ◽

Vol 28 (2) ◽

pp. 159-167 ◽

Cited By ~ 7

Author(s):

Janice D. Crist ◽

Kari M. Koerner ◽

Joseph T. Hepworth ◽

Alice Pasvogel ◽

Catherine A. Marshall ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Home Health Care ◽

Health Care Services ◽

Transitional Care ◽

Insurance Coverage ◽

Home Health ◽

Hospital Length Of Stay ◽

Care Services ◽

Hispanic White

Background:Transitional care, assisting patients to move safely through multiple health care settings, may be insufficient for older Hispanic patients. Purpose: Describe home health care services referral rates for Hispanic and non-Hispanic White (NHW) patients and factors that influence case managers’ (CMs’) discharge planning processes. Design: Organized by the Ethno-Cultural Gerontological Nursing Model, health records were reviewed ( n = 33,597 cases) and supplemented with qualitative description ( n = 8 CMs). Findings: Controlling for gender, insurance type, age, and hospital length of stay, NHW older adults received more home health care services referrals (odds ratio = 1.23). Insurance coverage was the most frequent determinant of CMs’ post–hospital care choices, rather than patients’ being Hispanic. NHW older adults were more likely to have insurance than Hispanic older adults. Implications: Insurance coverage being CMs’ primary consideration in determining patients’ dispositions is a form of systems-level discrimination for Hispanic vulnerable groups, which combined with other hospital-level constraints, should be addressed with policy-level interventions.

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Variations in hospital length of stay for diagnosis-related groups among health care institutions

Health Policy and Management ◽

10.4332/kjhpa.2006.16.2.077 ◽

2006 ◽

Vol 16 (2) ◽

pp. 77-95 ◽

Cited By ~ 5

Keyword(s):

Health Care ◽

Length Of Stay ◽

Diagnosis Related Groups ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Health Care Institutions

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Does Use of Home Health Care Impact Length Of Stay? † 1221

Pediatric Research ◽

10.1203/00006450-199704001-01240 ◽

1997 ◽

Vol 41 ◽

pp. 206-206

Author(s):

Virginia G. Nichols ◽

Brent J. Shelton

Keyword(s):

Health Care ◽

Length Of Stay ◽

Home Health Care ◽

Home Health

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Racial Disparities in Post-Acute Home Health Care Referral and Utilization Among Older Adults with Diabetes

10.20944/preprints202102.0039.v1 ◽

2021 ◽

Author(s):

Jamie M. Smith ◽

Olga F. Jarrín ◽

Haiqun Lin ◽

Tina Dharamdasani ◽

Jennifer Tsui ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Hospital Discharge ◽

Home Health Care ◽

The United States ◽

Home Health ◽

Urban Setting ◽

Hospital Length Of Stay ◽

Area Deprivation ◽

Administrative Claims

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

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Hospital Reimbursement for Adult Patients with Severe Sepsis Treated with Drotrecogin Alfa (Activated)

Hospital Pharmacy ◽

10.1177/001857870504000206 ◽

2005 ◽

Vol 40 (2) ◽

pp. 146-153 ◽

Cited By ~ 1

Author(s):

Brian S. Smith ◽

Walter S. Schroeder ◽

Gary R. Tataronis

Keyword(s):

Health Care ◽

Intensive Care Unit ◽

Severe Sepsis ◽

Intensive Care ◽

Length Of Stay ◽

Drotrecogin Alfa ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Drotrecogin Alfa Activated ◽

Related Group

Purpose Patients with severe sepsis are critically ill and use a high level of health care resources. The high resource utilization and lack of a specific diagnosis related group may lead to a significant loss in revenue for health care organizations secondary to inadequate reimbursement. The primary objective of this study is to quantify the difference in total cost and reimbursement in patients with severe sepsis treated with drotrecogin alfa (activated) (DAA) at our institution. Methods All patients between December 2001 and December 2003 diagnosed with severe sepsis and treated with DAA were evaluated. Demographic data, primary payer, diagnosis related group, hospital length of stay, length of medical/surgical stay, length of Intensive Care Unit stay, days on mechanical ventilation, total costs, and total reimbursement were determined by chart review and our institution's information systems. Results Data from a total of 71 patients were included. The total treatment cost was $6,294,590, and the total reimbursement received was $4,295,950. This represents a loss of $1,998,640 or $28,150 per patient. The primary factor contributing to this loss was Intensive Care Unit length of stay (P = 0.011). Conclusion Management of patients with severe sepsis is costly and strains hospital resources. The current reimbursement system does not allow for appropriate compensation. Therefore, in addition to efforts directed toward improved treatment strategies for severe sepsis, health care practitioners must target interventions to reduce hospital length of stay and maximize reimbursement.

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Preoperative Hyponatremia is a Risk Factor for Adverse 30-Day Outcomes Following Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0039-1701005 ◽

2020 ◽

Vol 04 (01) ◽

pp. 007-014

Author(s):

Joseph E. Tanenbaum ◽

Thomas T. Bomberger ◽

Derrick M. Knapik ◽

Steven J. Fitzgerald ◽

Nihar S. Shah ◽

...

Keyword(s):

Health Care ◽

Quality Improvement ◽

Total Hip Arthroplasty ◽

Length Of Stay ◽

Hip Arthroplasty ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Improvement Program ◽

Surgical Quality ◽

Total Hip

AbstractThe relationship between preoperative hyponatremia and 30-day outcomes following total hip arthroplasty (THA) is currently unknown. The present study used prospectively collected data to quantify the association between preoperative hyponatremia and odds of major morbidity (MM), longer length of stay, readmission, and reoperation within 30 days following THA. Patients who underwent THA between 2012 and 2014 were identified in the National Surgical Quality Improvement Program database using validated Current Procedural Terminology codes. Patients were included if they were either normonatremic or hyponatremic preoperatively. The outcome measures in this study were 30-day MM, hospital length of stay, 30-day readmission, and 30-day reoperation. A unique multivariable logistic regression model was used for each outcome to identify statistically significant associations between hyponatremia and the outcome of interest after adjusting for covariates. From 2012 to 2014, 59,236 THA procedures were recorded in National Surgical Quality Improvement Program, of which 55,611 patients were normonatremic and 3,051 patients were hyponatremic. After adjusting for covariates, preoperative hyponatremia was significantly associated with increased odds of MM (odds ratio [OR] = 1.14; 99% confidence interval [CI]: 1.01–1.30), 30-day reoperation (OR = 1.18; 99% CI: 1.02–1.36), and longer hospital length of stay (OR = 1.20; 99% CI: 1.13–1.27). Hyponatremia was not significantly associated with greater odds of 30-day readmission (OR = 0.91; 99% CI: 0.82–1.01). Preoperative hyponatremia was significantly associated with adverse 30-day outcomes following THA. As the U.S. health care system continues to transition toward value-based reimbursement that emphasizes health care quality, the results of the present study can be used to improve patient selection and preoperative counseling.

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