Predicting the impact of new health technologies on average length of stay: Development of a prediction framework

2005 ◽  
Vol 21 (4) ◽  
pp. 487-491 ◽  
Author(s):  
Sue Simpson ◽  
Claire Packer ◽  
Andrew Stevens ◽  
James Raftery
Keyword(s):  
Length Of Stay ◽  
Health Management ◽  
Average Length ◽  
New Technology ◽  
Length Of Hospital Stay ◽  
Health Technologies ◽  
Average Length Of Stay ◽  
Admission Policies ◽  
Mechanism Of Impact ◽  
The Impact

Objectives: The aim of this study was to develop a framework to predict the impact of new health technologies on average length of hospital stay.Methods: A literature search of EMBASE, MEDLINE, Web of Science, and the Health Management Information Consortium databases was conducted to identify papers that discuss the impact of new technology on length of stay or report the impact with a proposed mechanism of impact of specific technologies on length of stay. The mechanisms of impact were categorized into those relating to patients, the technology, or the organization of health care and clinical practice.Results: New health technologies have a variable impact on length of stay. Technologies that lead to an increase in the proportion of sicker patients or increase the average age of patients remaining in the hospital lead to an increase in individual and average length of stay. Technologies that do not affect or improve the inpatient case mix, or reduce adverse effects and complications, or speed up the diagnostic or treatment process should lead to a reduction in individual length of stay and, if applied to all patients with the condition, will reduce average length of stay.Conclusions: The prediction framework we have developed will ensure that the characteristics of a new technology that may influence length of stay can be consistently taken into consideration by assessment agencies. It is recognized that the influence of technology on length of stay will change as a technology diffuses and that length of stay is highly sensitive to changes in admission policies and organization of care.

scholarly journals Times of change in complex environments - Evaluating hospital co-payments in Palestine refugee camps

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S V Valente de Almeida ◽  
H Ghattas ◽  
G Paolucci ◽  
A Seita
Keyword(s):  
Length Of Stay ◽  
Policy Change ◽  
Negative Binomial ◽  
Negative Impact ◽  
Average Length ◽  
Lessons Learned ◽  
Policy Impact ◽  
Average Length Of Stay ◽  
Ex Post ◽  
The Impact

Abstract We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare. The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider. After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient. We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making. Key messages We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.

Impact of Length of Stay on Functional Outcomes of TBI Patients

2005 ◽  
Vol 71 (11) ◽  
pp. 920-930 ◽  
Author(s):  
M.L. Hawkins ◽  
F.D. Lewis ◽  
R.S. Medeiros
Keyword(s):  
Length Of Stay ◽  
Functional Outcomes ◽  
Inpatient Care ◽  
Average Length ◽  
Functional Independence ◽  
Average Length Of Stay ◽  
Group 2 ◽  
The Impact ◽  
Group 1

The purpose of this study was to compare the functional outcomes of two groups of patients with traumatic brain injury (TBI) with attention to the impact of reduced length of stay (LOS) in the trauma center (TC) and rehabilitation hospital (RH). From 1991 to 1994, 55 patients, Group 1, with serious TBI (Abbreviated Injury Scale score ≥3) were admitted to a level 1 TC and subsequently transferred to a comprehensive inpatient RH. These results have been previously published. From 1996 to 2002, 64 similarly injured patients, Group 2, received inpatient care at the same TC and RH. These patients had a marked decrease in length of stay. Functional Independence Measures (FIM) were obtained at admission (Adm), discharge (D/C), and at 1 year follow-up for both groups. The average length of stay at the TC dropped from 36 days in Group 1 to 26 days in Group 2. In addition, the average length of stay at the RH dropped from 46 days (Group 1) to 25 days (Group 2); overall, an average reduction of 31 days of inpatient care. Group 2 had significantly lower FIM scores at the time of RH discharge for self-care, locomotion, and mobility compared to Group 1. At the 1 year follow-up, however, there were no significant differences between Groups 1 and 2 in these FIM scores. FIM scores at 1 year were higher in Group 2 for communication (90% vs 71%) and social cognition (77% vs 49%) compared to Group 1. Over one-fourth of each group returned to work by the 1 year follow-up. Socially disruptive behavior occurred at least weekly in 28 per cent (Group 1) and 23 per cent (Group 2) of patients. The outcome for serious TBI is better than generally perceived. Reduction of inpatient LOS did not adversely affect the ultimate functional outcome. The decreased LOS placed a greater demand on outpatient rehabilitative services as well as a greater burden on the family of the brain-injured patient

MINI-SUMMARIES FROM THE U.K. HTA PROGRAMME

2001 ◽  
Vol 17 (2) ◽  
pp. 261-266
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Average Length ◽  
Clinical Pathways ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
The United States ◽  
Local Conditions ◽  
Orthopedic Rehabilitation ◽  
The Impact

SUMMARY POINTS[bull ] Geriatric service interventions after hip fracture are complex and strongly influenced by local conditions. The effectiveness of rehabilitation programs is uncertain, and comparative studies comparing different treatments and strategies are of poor to moderate quality.[bull ] Based on the available evidence, geriatric hip fracture and early supported discharge programs are probably cost-effective since they appear to shorten the average length of hospital stay and are associated with significantly increased rates of return to previous residential status. Clinical pathways also appear to reduce total length of stay in hospital.[bull ] Geriatric orthopedic rehabilitation units are unlikely to be cost-effective, but some frailer patients may benefit in respect of reduced readmission rates and need for nursing home placement.[bull ] Length of stay may be reduced by the introduction of prospective payment systems, but these have led to increased use of nursing homes in the United States.[bull ] There is no evidence that any of the programs evaluated are associated with changes in mortality. However, there are insufficient data to assess the impact of any program on level of function, morbidity, quality of life, or impact on carers.

scholarly journals Efficacy of a triage system to reduce length of hospital stay

2014 ◽  
Vol 204 (6) ◽  
pp. 480-485 ◽  
Author(s):  
P. Williams ◽  
E. Csipke ◽  
D. Rose ◽  
L. Koeser ◽  
P. McCrone ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Triage System ◽  
Traditional System ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Two Systems ◽  
Admission System ◽  
Novel Method

BackgroundAttempts have been made to improve the efficiency of in-patient acute care. A novel method has been the development of a ‘triage system’ in which patients are assessed on admission to develop plans for discharge or transfer to an in-patient ward.AimsTo compare a triage admission system with a traditional system.MethodLength of stay and readmission data for all admissions in a 1-year period between the two systems were compared using the participating trust's anonymised records.ResultsDespite reduced length of stay on the actual triage ward, the average length of stay was not reduced and the triage system did not lead to a greater number of readmissions. There was no significant difference in costs between the two systems.ConclusionsBased on our findings we cannot conclude that the triage system reduced length of stay, but we can conclude that it does not increase the number of readmissions as some have feared.

scholarly journals The evaluation of a highly specialist inpatient psychologist working with patients with high risk presentations in an acute mental health inpatient setting

2021 ◽  
Vol 17 (1) ◽  
pp. 29-40
Author(s):  
Lisa Wood ◽  
Claudia Alonso ◽  
Tirma Morera ◽  
Claire Williams
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Length Of Stay ◽  
Clinical Data ◽  
Average Length ◽  
Inpatient Setting ◽  
Slight Reduction ◽  
Average Length Of Stay ◽  
Restrictive Practice ◽  
The Impact

Objective: To evaluate the function and impact of a highly specialist psychologist working with high risk patients in an acute mental health inpatient setting. The impact was examined on outcomes such as risk related incidents, re-admission, average length of stay, and use of restrictive practice.<br/> Method: A mixed methods service evaluation of a pilot project was undertaken to examine the impact of the specialist psychologist role on these outcomes over a 17-month period. Demographic and clinical data was collected for 18 patients who were seen by the psychologist. Routinely collected clinical data examining risk incidents, re-admission rates, average length of stay, and use of restrictive practice, were also used to evaluate outcome across the evaluation period (at baseline and six-month follow-up).<br/> Results: The specialist psychologist provided input to patients' care and undertook a variety of direct and indirect work and training. Examination of descriptive routine clinical data indicated a slight reduction in risk related incidents, readmissions, and average length of stay after the introduction of the psychologist role, however these were not statistically significant.<br/> Conclusion: These initial findings suggest the potential for outcome improvement, but further, more robust research is required to see if such a role can have a significant impact on outcomes.

scholarly journals The impact of inpatient bed capacity on length of stay

2021 ◽  
Author(s):  
Brendan Walsh ◽  
Samantha Smith ◽  
Maev-Ann Wren ◽  
James Eighan ◽  
Seán Lyons
Keyword(s):  
Length Of Stay ◽  
Fixed Effects ◽  
Public Hospital ◽  
Negative Binomial ◽  
Average Length ◽  
Average Length Of Stay ◽  
Bed Capacity ◽  
Direction Of Causation ◽  
The Impact ◽  
Inpatient Length Of Stay

Abstract Objective Large reductions in inpatient length of stay and inpatient bed supply have occurred across health systems in recent years. However, the direction of causation between length of stay and bed supply is often overlooked. This study examines the impact of changes to inpatient bed supply, as a result of recession-induced healthcare expenditure changes, on emergency inpatient length of stay in Ireland between 2010 and 2015. Study design We analyse all public hospital emergency inpatient discharges in Ireland from 2010 to 2015 using the administrative Hospital In-Patient Enquiry dataset. We use changes to inpatient bed supply across hospitals over time to examine the impact of bed supply on length of stay. Linear, negative binomial, and hospital–month-level fixed effects models are estimated. Results U-shaped trends are observed for both average length of stay and inpatient bed supply between 2010 and 2015. A consistently large positive relationship is found between bed supply and length of stay across all regression analyses. Between 2010 and 2012 while length of stay fell by 6.4%, our analyses estimate that approximately 42% (2.7% points) of this reduction was associated with declines in bed supply. Conclusion Changes in emergency inpatient length of stay in Ireland between 2010 and 2015 were closely related to changes in bed supply during those years. The use of length of stay as an efficiency measure should be understood in the contextual basis of other health system changes. Lower length of stay may be indicative of the lack of resources or available bed supply as opposed to reduced demand for care or the shifting of care to other settings.

scholarly journals 1114 Getting it Right First Time: An Audit of Length of Hospital Stay for Mandibular Fractures

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
F Mitchell ◽  
J Parmar
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Maxillofacial Surgery ◽  
Length Of Hospital Stay ◽  
National Standard ◽  
Oral And Maxillofacial Surgery ◽  
Service Improvement ◽  
Mandibular Fractures ◽  
Average Length Of Stay ◽  
Mandible Fractures

Abstract Introduction GIRFT is a Department of Health programme, created to improve efficiency by providing data that gives departments a national standard to encourage reflection and service-improvement. The 2016 document in Oral and Maxillofacial Surgery, suggests the national average length of stay for isolated mandible fractures was 2 days, 1 day pre-operatively and 1 day post-operatively. This Audit aimed to investigate if all admissions in our trust met this standard, as a short stay reduces costs and improves patient experience. Method Data was collected for all isolated mandibular fracture admissions between January – September 2019, with 89 patients identified. Date of admission, surgery and discharge was recorded which allowed calculation of pre-operative, post-operative, and total stay. Results 78% of patients had surgery within 24 hours of admission. Admissions on a Saturday were most often delayed, with a mean pre-operative stay of 1.60 days and total stay of 2.55 days. Commonly the reason for delay was not recorded, or due to lack of theatre space. 92% of patients were discharged within 24 hours post-operatively. The average length of stay met the 2-day standard, with Monday admissions having the shortest average stay of 1.45 days. Conclusions Whilst the majority of patients are treated and discharged within 2 days, improvements and future audit would assist to get closer to the 100% target. Saturday saw the highest number of admissions, which also had the longest average length of stay. A dedicated weekend trauma list would reduce wait times but may be limited by staffing and theatre space.

scholarly journals Contribution of the BioFire® FilmArray® Meningitis/Encephalitis Panel:

2019 ◽  
Vol 12 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Kyle Dack ◽  
Stephanie Pankow ◽  
Elizabeth Ablah ◽  
Rosey Zackula ◽  
Maha Assi
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Medical Center ◽  
Antiviral Treatment ◽  
Length Of Hospital Stay ◽  
Average Length Of Stay ◽  
Regional Medical ◽  
Regional Medical Center ◽  
The Mean ◽  
Hospital Stay Duration

Introduction. Traditional evaluation of meningitis includes cerebrospinalfluid (CSF) culture and gram stain to pinpoint specific causalorganisms. The BioFire® FilmArray® Meningitis/Encephalitis (ME)Panel has been implemented as a more timely evaluation method.This study sought to assess if the BioFire® ME Panel was associatedwith a decreased length of stay or decreased antimicrobial durationwhen used in the diagnosis of meningitis or encephalitis.Methods.xA case, historical-control, chart review was performed onpatients admitted to a regional medical center with CSF pleocytosisduring Cohort 1 (the year prior to BioFire® ME Panel implementation)and Cohort 2 (the year after BioFire® ME Panel implementation).Length of hospital stay, duration of antimicrobials, and BioFire® MEPanel result were gathered and analyzed.Results. Average length of stay for both cohorts was about fourhospital days. Approximately three-fourths of all patients receivedantibiotic/antiviral treatment with an average of three days duration.No significant differences were observed between groups. The mean(median) duration of antimicrobials in the year prior to and afterthe BioFire® ME Panel implementation was 3.6 (3) and 3.1 (2) days,respectively (p = 0.835). The mean (median) length of stay in the yearprior to and after the BioFire® ME Panel implementation was 5.8 (4)and 5.4 (4) days, respectively (p = 0.941). Among the patients admittedafter the implementation of the BioFire® ME Panel, 4.3 % (n =2) had a positive bacterial result, 38.3% (n = 18) had a positive viralresult, and 57.4% (n = 27) had a negative result. Of the 27 negativeresults, 77.8% (n = 21) were treated with antimicrobial medication.Conclusions. This study suggested there is no difference betweenlength of stay or antimicrobial duration in presumed meningitis casesassessed with traditional methods as compared to the BioFire® MEPanel. Kans J Med 2019;12(1):1-3.

THE AVERAGE LENGTH OF STAY IN THE HOSPITAL OF INFANTS BORN PREMATURELY

PEDIATRICS ◽  
1948 ◽  
Vol 1 (1) ◽  
pp. 66-69
Author(s):  
HELEN M. WALLACE ◽  
LEONA BAUMGARTNER ◽  
MOLLY L. PARK
Keyword(s):  
Length Of Stay ◽  
American Literature ◽  
Premature Infants ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Care Program ◽  
Average Length Of Stay ◽  
Private Agency ◽  
Pediatric Consultation ◽  
Basic Medical

Any public or private agency administering a medical care program needs certain basic medical data to plan its program. In the field of maternal and child health, one fact of importance is the average length of hospital stay of newly born premature infants. This basic data assists in planning for such budgetary items as: reimbursement for hospital care; payment for pediatric consultation service; and estimation of the number of beds(incubators, heated cribs and bassinets) needed to care for the total number of premature infants born annually in any community. A review of the American literature for the past twenty years reveals that there is relatively little information on the average length of stay of newly born premature infants in hospitals. Table I summarizes the information available. It will be seen from Table I that there is considerable variation in the method of reporting. Some authors do not include premature infants weighing more than 5 pounds at birth; others include premature infants weighing more than 5½ pounds. There is also variation as to whether a particular series includes the premature infants who die in the hospital, as well as those who are discharged alive. Table I shows that, for the series including only those infants who survived in the hospital, the average stay ranges from 17.3 to 28.8 days, with the majority falling between 24 and 28 days. For the series including both the premature infants who survived and those who died in the hospital, the average stay ranges from

Relationship between nutritional status and length of hospital stay in oncological surgery.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13591-e13591
Author(s):  
Carl Meissner ◽  
Ronny Otto ◽  
Joerg Fahlke ◽  
Mathias Mueller ◽  
Karsten Ridwelski
Keyword(s):  
Length Of Stay ◽  
Nutritional Status ◽  
Hospital Stay ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Nutritional Therapy ◽  
Albumin Level ◽  
Average Length Of Stay

e13591 Background: In Germany, a serious illness is the main cause of malnutrition. Various studies have already shown that the length of time in hospital for various diseases and operations in malnourished patients increases. This leads to a deterioration in the quality of life of the patient and results in considerable costs for the health care system. Methods: In order to investigate the relationship between nutritional status and length of hospital stay, a patient group of 363 patients who had a tumor with the primary tumor in the gastrointestinal tract was first identified. All patients had an NRS score of 3 or greater and a meaningful laboratory with regard to protein and albumin levels and / or results of a bioelectrical impedance analysis. The average length of stay for these patients was determined depending on the various parameters. Results: The present study shows that malnourished patients have to stay in the hospital for between 2 and 11.1 days longer. When evaluating the NRS score, the protein and albumin level as well as the BCM and the ECM / BCM index, a longer hospital stay of malnourished patients compared to those who were not malnourished was demonstrated. The BMI is an insufficient parameter to describe the nutritional status. An extension of the length of hospital stay cannot be demonstrated only on the basis of the BMI. Conclusions: Since an inadequate nutritional status obviously affects the length of hospital stay in oncological patients, they should be examined early for malnutrition. The length of stay can be shortened through nutritional therapy measures, which also leads to a significant reduction in costs.

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