Length of Stay, Short Stay Units and Psychiatric Emergency Admissions

1989 ◽  
Vol 34 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Brian Baker ◽  
James Rochon
Keyword(s):  
Length Of Stay ◽  
Metropolitan Area ◽  
Psychiatric Emergency ◽  
Short Stay ◽  
General Hospitals ◽  
Emergency Admissions ◽  
Total Length ◽  
Major Metropolitan Area ◽  
One Year

Length of stay information was collected from 1,364 individuals over a one year period for five general hospitals in a major metropolitan area. The current set of data represents homogeneity in the nature of admissions and the type of facilities examined. Three of the hospitals operated short stay units. Significant differences in the total length of stay were observed according to age, sex and presence of psychosis but there were no unequivocal distinctions between short stay and conventional hospitals.

scholarly journals Can medical admission and length of stay be accurately predicted by emergency staff, patients or relatives?

2007 ◽  
Vol 31 (4) ◽  
pp. 633 ◽  
Author(s):  
Andrew W Dent ◽  
Tracey J Weiland ◽  
Lisa Vallender ◽  
Nicola E Oettel
Keyword(s):  
Length Of Stay ◽  
Vital Signs ◽  
Prediction Tool ◽  
Short Stay ◽  
Reasonable Accuracy ◽  
Appropriate Use ◽  
Medical Assessment ◽  
Convenience Sample ◽  
Emergency Admissions ◽  
Medical Symptoms

Objectives: To determine the accuracy of predictions of the need for hospital admission and, if admitted, length of stay (LOS) made early in an emergency attendance by emergency department (ED) doctors, nurses, patients and relatives, and the characteristics of ED presentations predictive of admission and short stays (~3 days). Methods: Prospective collection of predictions by medical and nursing staff, patients and relatives of ED departure status and LOS (1 day, 2-3 days, 4- 7 days or longer) of a convenience sample of adults presenting with medical symptoms. Predictions were made before full medical assessment and matched against actual departure status and LOS. Vital signs and demographics were recorded. Results: Seventy five percent (2159/2904; CI 73%?77%) of all admission predictions in 704 patients were correct with 85% (575/673; CI 81%- 88%) of doctors? predictions correct. Thirty-five percent (361/1024) of all LOS predictions for 331 patients were correct with 46% (122/268; CI 40%- 52%) of doctors? predictions correct. Risk factors for short-stay over longer admission included age less than 65, normal oxygen saturations and selfreferral. Conclusion: Emergency admissions can be predicted with reasonable accuracy but LOS is difficult to predict. Development of a prediction tool may facilitate streaming and appropriate use of short-stay units.

Characteristics of Psychiatric Hospital Absconders

1989 ◽  
Vol 154 (3) ◽  
pp. 368-371 ◽  
Author(s):  
Arden Randall Tomison
Keyword(s):  
Length Of Stay ◽  
Psychiatric Hospital ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Total Length ◽  
One Year ◽  
Lay Public

Absence of patients without leave is common in psychiatric hospitals, and causes anxiety to staff, relatives, and the lay public. Such incidents are difficult to predict. This study attempted to identify the characteristics of patients absconding from a UK hospital over one year. Numbers were small, as those patients discharged against advice and failing to return from leave were excluded. Absconders were predominantly male, young, compulsorily admitted, and discharged with a diagnosis of schizophrenia. They tended to be single, had many previous admissions, and a longer total length of stay, and the police were more often involved in their admission. Reasons for absconding and the implications for management of newly admitted psychiatric patients are discussed.

scholarly journals The Payment by Results (PbR) national tariff severely penalises efficiency and early hospital discharge

2009 ◽  
Vol 8 (3) ◽  
pp. 123-126
Author(s):  
Syed Munawer Alam ◽  
◽  
Alex Brown ◽  
Sulleman Moreea ◽  
Keyword(s):  
Length Of Stay ◽  
Hospital Discharge ◽  
Secondary Care ◽  
Healthcare Resource ◽  
Teaching Hospitals ◽  
Short Stay ◽  
Acute Medicine ◽  
Healthcare Resource Groups ◽  
One Year ◽  
Additional Income

The system of Payment by Results (PbR) was instituted in 2005 to reimburse secondary care for its activity. One of the features of PbR is the short stay tariff (SST), in which only 20-50% of the national tariff is paid if patients have a length of stay (LoS) of less than 2 days in hospital for certain Healthcare Resource Groups (HRGs) – or conditions. We analysed the admissions under Acute Medicine at Bradford Teaching Hospitals over a period of one year and identified the HRGs to which the SST applied. We used the 2007 PbR national tariff to calculate the additional income that would have been generated if these patients were kept in hospital for at least 2 days in order to avoid SST. We calculated an extra theoretical income of approximately £5 million if all these patients had a length of stay (LoS) more than 2 days to avoid the SST. Sixteen additional beds (assuming 85% occupancy) would have been required at a cost of around £1million per year to accommodate these patients. We show that the current PbR system is flawed and penalises hospitals with a higher turnover of patients.

scholarly journals The association between opening a short stay paediatric assessment unit and trends in short stay hospital admissions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Steve Turner ◽  
Edwin-Amalraj Raja
Keyword(s):  
Hospital Admissions ◽  
Geographic Region ◽  
Health Board ◽  
Short Stay ◽  
Emergency Admissions ◽  
Inpatient Ward ◽  
Assessment Unit ◽  
Stay Hospital ◽  
Clinical Referral ◽  
Health Boards

Abstract Background Many inpatient facilities in Scotland have opened short stay paediatric assessment units (SSPAU) which are clinical areas separate from the usual inpatient ward area and these are where most short stay (also called zero day) admissions are accommodated. Here we describe the effect of opening short stay paediatric assessment units (SSPAU) on the proportion of zero day admissions relative to all emergency admissions. Methods Details of all emergency medical paediatric admissions to Scottish hospitals between 2000 and 2013 were obtained, including the number of zero day admissions per month and health board (i.e. geographic region). The month and year that an SSPAU opened in each health board was provided by local clinicians. Results SSPAUs opened in 7 health boards, between 2004 and 2012. Health boards with an SSPAU had a slower rise in zero day admissions compared to those without SSPAU (0.6% per month [95% CI 0.04, 0.09]. Across all 7 health boards, opening an SSPAU was associated with a 13% [95% CI 10, 15] increase in the proportion of zero day admissions. When considered individually, zero day admissions rose in four health boards after their SSPAU opened, were unchanged in one and fell in two health boards. Independent of SSPAUs opening, there was an increase in the proportion of all admissions which were zero day admissions (0.1% per month), and this accelerated after SSPAUs opened. Conclusion Opening an SSPAU has heterogeneous outcomes on the proportion of zero day admissions in different settings. Zero day admissions could be reduced in some health boards by understanding differences in clinical referral pathways between health boards with contrasting trends in zero day admissions after their SSPAU opens.

COMMUNITY-WIDE PLANNING FOR CHILDREN'S HOSPITAL SERVICE IN A METROPOLITAN AREA

PEDIATRICS ◽  
1963 ◽  
Vol 32 (6) ◽  
pp. 1078-1086
Author(s):  
Robert M. Sigmond
Keyword(s):  
Metropolitan Area ◽  
Medical Science ◽  
Minimum Size ◽  
High Quality ◽  
General Hospitals ◽  
Medical Centers ◽  
Long Run ◽  
Effective Care ◽  
Pediatric Inpatient ◽  
High Quality Service

Community-wide planning of hospitals and related facilities in a metropolitan area helps to translate the miracles of modern medical science into high quality service for all at reasonable cost. Community-wide planning for children's inpatient services should encourage grouping of small segregated pediatric units in which most children receive care today. These small units interfere with provision of high quality, comprehensive care and are wasteful of scarce personnel and dollars. Experts should agree upon the minimum size unit in which effective care can be provided; this minimum would obviously be much larger than most units in existence today. To achieve this minimum, most general hospitals should affiliate with major general hospitals or children's medical centers at which their pediatric inpatient facilities could be grouped into a few large units. The children's medical centers should take leadership in exploring the feasibility and nature of such affiliations of which the key element is the medical staff relationship. Such affiliations are consistent with and conducive to valid objectives of children's medical centers: leadership in promotion of child health, child care, education and research. Failure of children's medical centers to develop such affiliations may have dire consequences in the long run.

The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emre Sarıkaya ◽  
Dilek Çiçek ◽  
Ebru Gök ◽  
Leyla Kara ◽  
Uğur Berber ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Control ◽  
Glycosylated Hemoglobin ◽  
Emergency Admissions ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
One Year

Abstract Objectives Coronavirus disease 2019 has caused a major epidemic worldwide, and lockdowns became necessary in all countries to prevent its spread. This study aimed to evaluate the effects of staying-at-home practices on the metabolic control of children and adolescents with type 1 diabetes during the pandemic period. Materials and Methods Eighty-nine patients younger than 18 years old who were diagnosed with type 1 diabetes at least one year before the declaration of the pandemic were included in the study. The last visit data of the patients before and after the declaration of the pandemic, and the frequency of presentation of diabetes-related emergencies from one year after diagnosis of type 1 diabetes to the declaration of the pandemic, and from the declaration of the pandemic to the last visit after the pandemic declaration were compared. Results The total number of patients was 89, and 48 (53.9%) were boys. The mean (± standard deviation [SD]) age at diagnosis was 8.4 ± 3.7 years (boys 7.9 ± 3.6 years; girls 8.9 ± 3.9 years). There was no statistically significant difference when the SD values of the anthropometric measurements, and the glycosylated hemoglobin (HbA1c) and lipid profile tests were compared. However, the frequency of admission to the emergency service related to diabetes was significantly different. Conclusions Although the pandemic did not significantly affect the metabolic and glycemic controls of the children with type 1 diabetes included in this study, an increase in the frequency of diabetes-related emergency admissions was noted.

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