scholarly journals Resource Use Study in COPD (RUSIC): A prospective Study to Quantify the Effects of COPD Exacerbations on Health Care Resource Use Among COPD Patients

2007 ◽  
Vol 14 (3) ◽  
pp. 145-152 ◽  
Author(s):  
J Mark FitzGerald ◽  
Jennifer M Haddon ◽  
Carole Bradley-Kennedy ◽  
Lisa Kuramoto ◽  
Gordon T Ford ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Home Care ◽  
Resource Use ◽  
Average Length ◽  
Forced Expiratory Volume ◽  
Health Care Resource ◽  
Copd Exacerbations ◽  
Average Length Of Stay ◽  
Acute Exacerbations

BACKGROUND: There is increasing interest in health care resource use (HRU) in Canada, particularly in resources associated with acute exacerbations of chronic obstructive pulmonary disease (COPD).OBJECTIVE: To identify HRU due to exacerbations of COPD.METHODS: A 52-week, multicentre, prospective, observational study of HRU due to exacerbations in patients with moderate to severe COPD was performed. Patients were recruited from primary care physicians and respirologists in urban and rural centres in Canada.RESULTS: In total, 524 subjects (59% men) completed the study. Their mean age was 68.2±9.4 years, with a forced expiratory volume in 1 s of 1.01±0.4 L. Patients had significant comorbidities. There were 691 acute exacerbations of COPD, which occurred in 53% of patients: 119 patients (23%) experienced one acute exacerbation, 70 patients (13%) had two acute exacerbations and 89 patients (17%) had three or more acute exacerbations. Seventy-five patients were admitted to hospital, with an average length of stay of 13.2 days. Fourteen of the patients spent time in an intensive care unit (average length of stay 5.6 days). Factors associated with acute exacerbations of COPD included lower forced expiratory volume in 1 s (P<0.001), high number of respiratory medications prescribed (P=0.037), regular use of oral corticosteroids (OCSs) (P=0.008) and presence of depression (P<0.001). Of the 75 patients hospitalized, only 53 received OCSs, four received referral for rehabilitation and 15 were referred for home care.CONCLUSIONS: The present study showed a high prevalence of COPD exacerbations, which likely impacted on HRU. There was evidence of a lack of appropriate management of exacerbations, especially with respect to use of OCSs, and referral for pulmonary rehabilitation and home care.

scholarly journals Designing Hospital Key Performance Indicators for Academic Centers: Measuring the Average Length of Stay

2016 ◽  
Vol 6 (1) ◽  
pp. 5-11
Author(s):  
Omar A. Ayoub ◽  
Mohamed N. AlAma ◽  
Kamal M. AlGhalayini ◽  
Wesam A. Alhejily ◽  
Mohammed S. Abdulwahab ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Performance Indicator ◽  
Average Length ◽  
Performance Measure ◽  
University Hospital ◽  
Patient Specific ◽  
Design Quality ◽  
Average Length Of Stay ◽  
Risk Patients

Background: Length of stay is an important performance indicator for hospital management and a key measure of health care efficiency. This paper aims to determine the average length of stay in our center and the factors that influence it. We also investigate whether our hospital's length of stay is a key performance measure that can be used to design quality improvement initiatives. Methods: We performed a retrospective analysis of hospitalizations at the Multi-disciplinary Internal Medicine Department of King Abdulaziz University Hospital, Jeddah between 2010 and 2013. We collected data including demographics, admitting diagnosis, admitting unit, treatments administered, and history of transfer from the Intensive Care Unit. Results: The mean length of stay was 5.9 (6.8) days. Patients admitted through the Emergency Department were more likely to have a longer hospital stay compared with those admitted through Day Care or the Outpatient Department (P < 0.001). Expatriates (P < 0.001), bedridden patients (P = 0.02), and those who received prophylaxis for deep venous thrombosis (P < 0.001) were more likely to have a longer length of stay than the rest of the sample. Furthermore, patients admitted in the morning hours had a significantly shorter length of stay than those admitted in the evening hours (P < 0.001). Conclusion: The length of stay among patients at our department is affected by hospital- or patient-specific factors. Health care can be improved by identifying and monitoring the length of stay in high-risk patients.  

scholarly journals National University Hospital discharge survey in the Islamic Republic of Iran

2000 ◽  
Vol 6 (2-3) ◽  
pp. 402-408
Author(s):  
S. M. Reza Khatami ◽  
S. K. Kamrava ◽  
B. Ghatehbaghi ◽  
M. Mirzazadeh
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Hospital Discharge ◽  
Average Length ◽  
Health Care Service ◽  
Health Care Facilities ◽  
University Hospital ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay

We aimed to determine the rate of hospital discharge, average length of stay and bed occupancy rate in different hospital wards around the country. The survey consisted of health care service activities from 452 university-related hospitals in the country with a total of 59 348 beds. Because of missing data, the use of 56 315 of these beds was analysed. The countrywide discharge rate was 68.32 patients/1000 population per year with an average length of stay of 3.60 days and a bed occupancy rate of 57.44%. The data could be used to design a framework for prediction of inpatient health care facilities needed in the future

Efficiency indicators of the round-the-clock hospital beds of the oncologic profile in the Russian Federation

2020 ◽  
pp. 12-18
Author(s):  
V. A. Evdakov ◽  
◽  
M. N. Banteva ◽  
E. M. Manoshkina ◽  
Y. Y. Melnikov ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Russian Federation ◽  
Average Length ◽  
Hospitalization Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay ◽  
Hospital Beds ◽  
Federal Districts ◽  
The Russian Federation

The steady growth trend of oncological diseases in Russia in recent years requires a response from the health care system: development of prevention aimed at early detection of diseases; improvement of methods of diagnostics and treatment of oncopathology; improving the quality and effectiveness of medical care. A i m : to identify trends in changes of the neoplasms incidence and performance indicators of oncological beds for round-the-clock stay of the state health care system in the Russian Federation, federal districts and regions of the Russian Federation in dynamics for 2010–2019. M a t e r i a l s a n d m e t h o d s . Using the data of federal statistical observation (forms NoNo. 12, 30) by the method of descriptive statistics, the main indicators of the neoplasms incidence in the population are analyzed, as well as the work of round-the-clock oncological beds in the Russian Federation, federal districts and regions of the Russian Federation in dynamics for 2010–2019. R e s u l t s . On the background of an increase in the neoplasms incidence in the population (by 24.9%), including malignant (1.5 times), for the period 2010–2019 in the Russian Federation increased: the absolute number of oncology beds of round-the-clock stay from 30,970 to 36,186 (+ 16.8%), the provision with these beds from 2.17 to 2.47 per 10,000 population (+ 13.8%), hospitalization rate from 6.1 to 9.6 per 1000 population (+ 57.4%), and decreased: the average length of stay in an oncological bed (from 12.1 days to 8.4 – by 30.6%), as well as the average bed occupancy per year (from 345 to 330 days – by 4.3%). The extreme values of the indicators of the hospitalization rate for round-the-clock oncological beds in the regions of the Russian Federation in 2019 differ 12.8 times, the provision of these beds – 9.2 times, the average bed occupancy per year – 1.5 times, the average length of stay in a bed – 2.4 times. Mortality in oncological hospital beds increased from 0.76% in 2010 to 0.95% in 2019 (by 25%). C o n c l u s i o n . The 24-hour oncological bed capacity, against the background of the growth of oncological morbidity, has naturally increased, but at the same time it is characterized by an extreme disproportionality of development in the Federal Districts and the regions of the Russian Federation. Optimization of the bed fund should be carried out based on the objective needs of a particular region, taking into account its characteristics and with the simultaneous development of alternative medical services.

scholarly journals 163 Rehabilitation to Nursing Home - The Waiting Period

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Adefunke Salawu ◽  
Jaimon Palatty ◽  
Marian Glynn
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Length Of Stay ◽  
Home Care ◽  
Transitional Care ◽  
Average Length ◽  
Nursing Home Care ◽  
Care Needs ◽  
Complex Needs ◽  
Average Length Of Stay

Abstract Background The average application processing time for the National Nursing Home Support Scheme (NHSS) has seen drastic improvement from 15 weeks in 2014 to 4 weeks in 20161. There is no available data of the duration of stay in rehabilitation beds after approval of NHSS application and reasons for delay in transition to nursing home. Aims (1) To examine average length of stay in rehabilitation before multidisciplinary team (MDT) decision is made for nursing home care. (2) To examine average length of stay in rehabilitation bed from the time of NHSS approval to discharge into nursing home. (3) To examine reasons for delay in discharge to nursing home after NHSS approval. Methods A retrospective chart review of patients discharged into nursing homes between January to June, 2018 from geriatric rehabilitation units. Data collected include age, length of stay in rehabilitation unit before multidisciplinary decision was made in conjunction with patients/family to seek nursing home care (LOS1), Length of stay in rehabilitation bed following decision for nursing home care (LOS 2). Reasons for the delay in the transition from rehabilitation bed to nursing home bed were also documented. Results Seventeen patients were discharged into nursing homes, LOS1 of 43.12 days and LOS2 of 50 days. Complexity of application in terms of financial evaluation especially for patients who were deemed cognitively incapable of managing their finances, lack of suitable nursing homes for patients with complex needs/challenging behaviours, family dynamics with regards to choice of nursing homes and medical stability to facilitate such transfers were reasons for delay in transition to nursing home beds. Conclusion Transitional care beds, which are generally acknowledged to be more appropriate to these patients' care needs and are less expensive than rehabilitation beds, need to be utilized more. Education of healthy adults over 65 years to proactively plan for future care needs and promote awareness of legislatures regarding capacity and decision making.

scholarly journals Factors related to the change in Swiss inpatient costs by disease: a 6-factor decomposition

2021 ◽  
Vol 22 (2) ◽  
pp. 195-221
Author(s):  
Michael Stucki
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Population Size ◽  
Average Length ◽  
Positive Association ◽  
Inpatient Cost ◽  
Sex Structure ◽  
Average Length Of Stay ◽  
Swiss Canton ◽  
Factor Decomposition

AbstractThere is currently little systematic knowledge about the contribution of different factors to the increase in health care spending in high-income countries such as Switzerland. The aim of this paper is to decompose inpatient care costs in the Swiss canton of Zurich by 100 diseases and 42 age/sex groups and to assess the contribution of six factors to the change in aggregate costs between 2013 and 2017. These six factors are population size, age and sex structure, inpatient treated prevalence, utilization in terms of stays per patient, length of stay per case, and costs per treatment day. Using detailed inpatient cost data at the case level, we find that the most important contributor to the change in disease-specific costs was a rise in costs per treatment day. For most conditions, this effect was partly offset by a reduction in the average length of stay. Changes in population size accounted for one third of the total increase, but population structure had only a small positive association with costs. The most expensive cases accounted for the largest part of the increase in costs, but the magnitude of this effect differed across diseases. A better understanding of the factors related to cost changes at the disease level over time is essential for the design of targeted health policies aiming at an affordable health care system.

scholarly journals Cost Effectiveness of Tyrosine Kinase Inhibitor (TKIs) Therapy in Chronic Myelogenous Leukemia (CML) in Comparison to Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) Based on the Nationwide Inpatient Sample (NIS) Database from 2002 to 2011

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4486-4486
Author(s):  
Indumathy Varadarajan ◽  
Parshva Patel ◽  
Ravindra Sangitha ◽  
Kristine Ward ◽  
Maneesh Jain ◽  
...  
Keyword(s):  
Health Care ◽  
Stem Cell ◽  
Length Of Stay ◽  
Average Length ◽  
Myelogenous Leukemia ◽  
Charge Ratio ◽  
Average Length Of Stay ◽  
Age Related ◽  
The Cost ◽  
Transplant Procedure

Abstract Background The introduction of Imatinib in 2001 has brought a paradigm shift in the management of CML. Patients on TKI therapy continue to require hospitalizations, however, for progressive disease, treatment side effects and other unrelated causes. In our study we compared the cost of inpatient health care, mortality, length of stay (LOS) and complications for patients who had stem cell transplants to those on TKI therapy. Methods We queried the NIS database from the Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality between 2002-2011 using ICD-9 code 205.1 for CML in the primary and secondary diagnosis fields. Patients 18 years or older were included in the analysis. Cost of hospitalization was adjusted for inflation in reference to 2011 and cost to charge ratio. We analyzed the trend in hospitalizations, cost and mortality. Linear and logistic regression models were generated to evaluate multivariate predictors of LOS, cost, mortality and complications. Odds ratios and odds estimates were generated comparing the group that underwent HSCT to the group that was treated with TKI therapy. We compared three groups: patients admitted for the transplant procedure (BMT procedure), patients readmitted post HSCT, and patients treated with TKIs. Multivariate analysis for complications from CML included splenic infarct, septic shock, splenomegaly, blast crises and DIC. Complications of graft versus host disease and graft rejection were included as they were complications of allogeneic transplant that warranted hospitalization. Age-related comorbidities, such as atrial fibrillation, congestive heart failure, and acute and chronic renal failure were also analyzed to further delineate the reason for hospitalization. A p value of <0.05 was considered significant. Results A total of 38,950 hospitalizations (weighted n= 19,1285) were analyzed (male 54.6% and age 65.9±0.08). There was a decrease of 81.96 % in mortality from 2002 to 2011 (p<0.0001). The average age was 66.7 years in the non-transplant group, and 45.6 years in the transplant group (p = 0.0016). 64% in the TKI group had Medicare, compared to 23.7% in the transplant group (p<0.0001). The inpatient mortality for transplant was 8.9%, but was 6.3% in the group readmitted after a successful transplant. It was 7.9 % in the TKI group (p = 0. 032). Admissions due to age-related co-morbidities was 28.5 % in the transplant group and 50.8% in the TKI group (p<0.0001). Only 14% of patients in the TKI group were admitted for CML related problems vs. 23.7% in the transplant group (0.0001). The average length of stay was 7.05 days in the TKI group and 18.4 days in the transplant group. The average length for the transplant procedure was 33.85 days (p<0.0001). The average cost of hospitalization in the transplant group was $173,780, and was $46,955 in the TKI group. The transplant procedure cost $338,229 (p<0.0001). The odds of mortality (OR) are in favor of TKI therapy with an OR of 1.9 against the transplant procedure. Discussion Patients on TKI therapy have a lower mortality, average length of stay and hospitalization cost compared to the transplant group. The main reasons for hospital admission for patients on TKI therapy were age-related comorbidities, rather than complications of CML. The mortality in the TKI group was lower than the HSCT group. However, the yearly cost of TKI therapy must be taken into account for health care costs of non-transplant patients. At present, Imatinib costs $92,000/ year and Dasatinib $118,000/year. Hence, Imatinib therapy for even 4 years would be more expensive than a transplant. Therefore, TKI therapy provides improved mortality and shorter length of hospital stay at the cost of a net higher expense. Disclosures No relevant conflicts of interest to declare.

scholarly journals Length of Stay of Orthopaedic Inpatients at a Teaching Hospital in Eastern Part of Nepal

2015 ◽  
Vol 53 (199) ◽  
pp. 180-183 ◽  
Author(s):  
Bibhuti Nath Mishra ◽  
Anuja Jha ◽  
Era Maharjan ◽  
Mahima Limbu ◽  
Sanjaya Sah ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Epidemiological Study ◽  
Average Length ◽  
Care Center ◽  
Third Party ◽  
Tertiary Level ◽  
Health Care Center ◽  
Average Length Of Stay

Introduction: This study aimed to analyze the average length of stay of all inpatients in the department of Orthopaedics and to compare the variations in hospital stay between age, gender, traumatic and non-traumatic co-morbidities and modality of payment. Methods: This hospital based retrospective descriptive epidemiological study was based on patients discharged from a tertiary level health care center of eastern Nepal. Registry data of 1 year was used to calculate length of stay and analyze the variations. Results: Average length of stay was 10.5 days. It was 10.7 days for males and 10.1 days for females. It was 10.12 days for patients paying themselves for their treatment whereas 14.98 days for patients receiving reimbursement (third party payment). Conclusions: Average length of stay was more in elderly and patients of trauma (longest in pelvis injury). It was 1.5 times longer for patients receiving reimbursement for treatment.  Keywords: length of stay; non-traumatic co-morbidities; trauma; third party payment.  

scholarly journals Quantifying the direct secondary health care cost of seasonal influenza in England

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joe W. E. Moss ◽  
Craig Davidson ◽  
Richard Mattock ◽  
Ilana Gibbons ◽  
Stuart Mealing ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Seasonal Influenza ◽  
Hospital Admissions ◽  
Health Care Cost ◽  
Average Length ◽  
Age Groups ◽  
Average Length Of Stay ◽  
Secondary Health Care ◽  
The Uk

Abstract Background The winter pressure often experienced by NHS hospitals in England is considerably contributed to by severe cases of seasonal influenza resulting in hospitalisation. The prevention planning and commissioning of the influenza vaccination programme in the UK does not always involve those who control the hospital budget. The objective of this study was to describe the direct medical costs of secondary care influenza-related hospital admissions across different age groups in England during two consecutive influenza seasons. Methods The number of hospital admissions, length of stay, and associated costs were quantified as well as determining the primary costs of influenza-related hospitalisations. Data were extracted from the Hospital Episode Statistics (HES) database between September 2017 to March 2018 and September 2018 to March 2019 in order to incorporate the annual influenza seasons. The use of international classification of disease (ICD)-10 codes were used to identify relevant influenza hospitalisations. Healthcare Resource Group (HRG) codes were used to determine the costs of influenza-related hospitalisations. Results During the 2017/18 and 2018/19 seasons there were 46,215 and 39,670 influenza-related hospital admissions respectively. This resulted in a hospital cost of £128,153,810 and £99,565,310 across both seasons. Results showed that those in the 65+ year group were associated with the highest hospitalisation costs and proportion of in-hospital deaths. In both influenza seasons, the HRG code WJ06 (Sepsis without Interventions) was found to be associated with the longest average length of stay and cost per admission, whereas PD14 (Paediatric Lower Respiratory Tract Disorders without Acute Bronchiolitis) had the shortest length of stay. Conclusion This study has shown that influenza-related hospital admissions had a considerable impact on the secondary healthcare system during the 2017/18 and 2018/19 influenza seasons, before taking into account its impact on primary health care.

scholarly journals Colonization and Infection With MRSA and CRKP and Its Result in an Increased Mortality Rate Within the Intensive Care and High-Dependency Units in Barbados

2020 ◽  
Vol 41 (S1) ◽  
pp. s173-s174
Author(s):  
Keisha Gustave
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
High Mortality ◽  
Average Length ◽  
Cohort Analysis ◽  
Health Concern ◽  
Queen Elizabeth Hospital ◽  
Surveillance Program ◽  
Average Length Of Stay ◽  
High Dependency

Background: Methicillin-resistant Staphylococcus aureus(MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are a growing public health concern in Barbados. Intensive care and critically ill patients are at a higher risk for MRSA and CRKP colonization and infection. MRSA and CRKP colonization and infection are associated with a high mortality and morbidly rate in the intensive care units (ICUs) and high-dependency units (HDUs). There is no concrete evidence in the literature regarding MRSA and CRKP colonization and infection in Barbados or the Caribbean. Objectives: We investigated the prevalence of MRSA and CRKP colonization and infection in the patients of the ICU and HDU units at the Queen Elizabeth Hospital from 2013 to 2017. Methods: We conducted a retrospective cohort analysis of patients admitted to the MICU, SICU, and HDU from January 2013 through December 2017. Data were collected as part of the surveillance program instituted by the IPC department. Admissions and weekly swabs for rectal, nasal, groin, and axilla were performed to screen for colonization with MRSA and CRKP. Follow-up was performed for positive cultures from sterile isolates, indicating infection. Positive MRSA and CRKP colonization or infection were identified, and patient notes were collected. Our exclusion criteria included patients with a of stay of <48 hours and patients with MRSA or CRKP before admission. Results: Of 3,641 of persons admitted 2,801 cases fit the study criteria. Overall, 161 (5.3%) were colonized or infected with MRSA alone, 215 (7.67%) were colonized or infected with CRKP alone, and 15 (0.53%) were colonized or infected with both MRSA and CRKP. In addition, 10 (66.6%) of patients colonized or infected with MRSA and CRKP died. Average length of stay of patients who died was 50 days. Conclusions: The results of this study demonstrate that MRSA and CRKP cocolonization and coinfection is associated with high mortality in patients within the ICU and HDU units. Patients admitted to the ICU and HDU with an average length of stay of 50 days are at a higher risk for cocolonization and coinfection with MRSA and CRKP. Stronger IPC measures must be implemented to reduce the spread and occurrence of MRSA and CRKP.Funding: NoneDisclosures: None

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