Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California

JAMA ◽  
1991 ◽  
Vol 266 (1) ◽  
pp. 73-79 ◽  
Author(s):  
P. D. Cleary
2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Rachel Heard ◽  
Maja Kopczynska ◽  
Michal Woyton ◽  
Elizabeth Allen ◽  
Madeline Garcia ◽  
...  

Abstract Aims Emergency general surgical (EGS) services have faced new challenges during the coronavirus pandemic. This study compared all EGS presentations before, during and after the first UK national lockdown between March and May 2020. Methods All EGS patients presenting to our centre in four separate weeks were included. These weeks represented ‘pre-lockdown’, ‘early lockdown’, ‘established lockdown’ and ‘post lockdown’ groups. Demographic data, treatment, admission and outcomes were collected for all patients and compared between groups. Results 178 patients accounted for 214 EGS attendances over four weeks. Attendances decreased from 74 pre-lockdown, to 43 in early lockdown, 32 in late lockdown and rose to 65 in the post lockdown group. Significantly more patients received repeat outpatient reviews in the lockdown groups (p = 0.002). Length of stay was significantly reduced in established lockdown (0.5 days vs. 2 days pre-lockdown, p = 0.042). There was a trend towards conservative management of surgical pathology in the lockdown groups (65% vs 47% pre and post-lockdown, p = 0.10). No very elderly or frail EGS patients presented during the lockdown study period. There was no evidence of delay to presentation. Conclusions The COVID-19 pandemic and UK Coronavirus lockdown resulted in a large decrease in EGS admissions and alteration in characteristics of these admissions. New national guidance during the pandemic advocated ambulatory and conservative management of surgical conditions where possible and is reflected in our cohort. These changes reverted almost back to pre-lockdown state the week following the easing of the first UK national lockdown.


2000 ◽  
Vol 46 (7) ◽  
pp. 955-966 ◽  
Author(s):  
Donald S Young ◽  
Bruce S Sachais ◽  
Leigh C Jefferies

Abstract Background: To date there have been no studies identifying and comparing the component costs to treat a large number of diseases for hospitalized inpatients. Methods: Hospital costs were analyzed for 486 diagnosis-related groups (DRGs) relating to >1.3 million patient discharges from 60 University Hospital members of the University HealthSystems Consortium. For each DRG, length of stay, total cost, and key cost components were analyzed, including accommodation, intensive care, and surgery. Results: In general, total costs of diseases classified as surgical exceeded those classified as medical. Diseases involving organ transplantation typically cost more than other diseases. However, within the studied population, the two DRGs accounting for most total healthcare dollars were percutaneous cardiovascular procedures and management of neonates with immaturity or respiratory failure. Conclusions: Considering six key cost components, as well as disease complexity and length of stay, the best predictors of total costs for medical conditions were the length of stay and accommodation (housing, meals, nursing services) costs, whereas for surgical conditions, the best predictor of total costs was laboratory costs. This analysis may be used within an individual institution to identify surgical or medical diagnoses with total or component costs at variance with the group mean. A hospital may focus its cost reduction efforts to make decisions to expand, alter, or eliminate particular clinical programs based on comparison of its own total and component costs with those from other hospitals in the database.


2001 ◽  
Vol 120 (5) ◽  
pp. A403-A404
Author(s):  
J HARRISON ◽  
J ROTH ◽  
R COHEN

2011 ◽  
Vol 4 (7) ◽  
pp. 19
Author(s):  
MARY ELLEN SCHNEIDER

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