scholarly journals The impact of hospital harm on length of stay, costs of care and length of person-centred episodes of care: a retrospective cohort study

2019 ◽  
Vol 191 (32) ◽  
pp. E879-E885 ◽  
Author(s):  
Lauren Tessier ◽  
Sara J.T. Guilcher ◽  
Yu Qing Bai ◽  
Ryan Ng ◽  
Walter P. Wodchis
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Costs Of Care ◽  
Episodes Of Care ◽  
The Impact

SP7.1.7 The impact of surgical subspecialisation on patient outcomes in those admitted with gallstone disease in the North of England: a retrospective cohort study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Julia McGovern ◽  
John Young ◽  
Leo Brown ◽  
Ross McLean
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Patient Outcomes ◽  
Conservative Management ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Gallstone Disease ◽  
Mortality Data ◽  
The North ◽  
The Impact

Abstract The management of gallstone disease has evolved over time and includes laparoscopic and open cholecystectomy, interventional radiology, endoscopic intervention and conservative management. Subspecialisation within general surgery is commonplace, allowing development of specialist skillsets. The aim of this study is to assess the impact of consultant subspecialisation on patient outcomes in those admitted with gallstone disease. A retrospective cohort study - data was collected on patients admitted with gallstone disease in the North of England between 2002 and 2016. Subspecialisation was categorised as Upper GI or other general subspecialties. The primary outcome of interest was overall 30-day mortality; secondary outcomes included surgical approach and length of stay. A total of 62,286 patients were admitted with gallstone disease. Overall 30-day mortality was 2.1%. The UGI specialists had a higher operative rate - 21.5% vs 10.7% (<0.001) than their colleagues including performing more laparoscopic cholecystectomies– 15.6% vs 6.4% (<0.001), and on-table cholangiogram (OTC) – 3.5% vs 1.5% (p < 0.001). 22,071 patients were diagnosed with acute cholecystitis. Non-UGI Consultants preferred conservative management (76.5% vs 59.0% - p < 0.001) which did not significantly affect 30-day mortality. Data was analysed using IBM SPSS Statistics. Categorical data were compared with chi-square test, and continuous data with t-test or ANOVA. Statistical significance was defined as a p value of ≤ 0.05. UGI consultants performed significantly more “hot gallbladders” than their non-UGI counterparts. UGI consultants choose to operate laparoscopically and perform significantly more OTCs, likely reducing need for pre-operative MRCP but not significantly reducing overall 30-day mortality or length of stay.

scholarly journals Threat of COVID-19 impacting on a quaternary healthcare service: a retrospective cohort study of administrative data

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045975
Author(s):  
Elissa McNamara ◽  
Leanne Saxon ◽  
Katherine Bond ◽  
Bruce CV Campbell ◽  
Jo Douglass ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Outpatient Visits ◽  
Episodes Of Care ◽  
Transmission Period ◽  
The Impact

ObjectivesThe threat of a pandemic, over and above the disease itself, may have significant and broad effects on a healthcare system. We aimed to describe the impact of the SARS-CoV-2 pandemic (during a relatively low transmission period) and associated societal restrictions on presentations, admissions and outpatient visits.DesignWe compared hospital activity in 2020 with the preceding 5 years, 2015–2019, using a retrospective cohort study design.SettingQuaternary hospital in Melbourne, Australia.ParticipantsEmergency department presentations, hospital admissions and outpatient visits from 1 January 2015 to 30 June 2020, n=896 934 episodes of care.InterventionIn Australia, the initial peak COVID-19 phase was March–April.Primary and secondary outcome measuresSeparate linear regression models were fitted to estimate the impact of the pandemic on the number, type and severity of emergency presentations, hospital admissions and outpatient visits.ResultsDuring the peak COVID-19 phase (March and April 2020), there were marked reductions in emergency presentations (10 389 observed vs 14 678 expected; 29% reduction; p<0.05) and hospital admissions (5972 observed vs 8368 expected; 28% reduction; p<0.05). Stroke (114 observed vs 177 expected; 35% reduction; p<0.05) and trauma (1336 observed vs 1764 expected; 24% reduction; p<0.05) presentations decreased; acute myocardial infarctions were unchanged. There was an increase in the proportion of hospital admissions requiring intensive care (7.0% observed vs 6.0% expected; p<0.05) or resulting in death (2.2% observed vs 1.5% expected; p<0.05). Outpatient attendances remained similar (30 267 observed vs 31 980 expected; 5% reduction; not significant) but telephone/telehealth consultations increased from 2.5% to 45% (p<0.05) of total consultations.ConclusionsAlthough case numbers of COVID-19 were relatively low in Australia during the first 6 months of 2020, the impact on hospital activity was profound.

Urine Culture on Admission Impacts Antibiotic Use and Length of Stay: A Retrospective Cohort Study

2018 ◽  
Vol 39 (5) ◽  
pp. 547-554 ◽  
Author(s):  
Molly J. Horstman ◽  
Andrew M. Spiegelman ◽  
Aanand D. Naik ◽  
Barbara W. Trautner
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Urine Culture ◽  
Antibiotic Use ◽  
The United States ◽  
Targeted Interventions ◽  
Bed Days ◽  
The Impact

OBJECTIVETo examine the impact of urine culture testing on day 1 of admission on inpatient antibiotic use and hospital length of stay (LOS).DESIGNWe performed a retrospective cohort study using a national dataset from 2009 to 2014.SETTINGThe study used data from 230 hospitals in the United States.PARTICIPANTSAdmissions for adults 18 years and older were included in this study. Hospitalizations were matched with coarsened exact matching by facility, patient age, gender, Medicare severity-diagnosis related group (MS-DRG), and 3 measures of disease severity.METHODSA multilevel Poisson model and a multilevel linear regression model were used to determine the impact of an admission urine culture on inpatient antibiotic use and LOS.RESULTSMatching produced a cohort of 88,481 patients (n=41,070 with a culture on day 1, n=47,411 without a culture). A urine culture on admission led to an increase in days of inpatient antibiotic use (incidence rate ratio, 1.26; P<.001) and resulted in an additional 36,607 days of inpatient antibiotic treatment. Urine culture on admission resulted in a 2.1% increase in LOS (P=.004). The predicted difference in bed days of care between admissions with and without a urine culture resulted in 6,071 additional bed days of care. The impact of urine culture testing varied by admitting diagnosis.CONCLUSIONSPatients with a urine culture sent on day 1 of hospital admission receive more days of antibiotics and have a longer hospital stay than patients who do not have a urine culture. Targeted interventions may reduce the potential harms associated with low-yield urine cultures on day 1.Infect Control Hosp Epidemiol 2018;39:547–554

1242-P: The Impact of Telehealth on the Management of Diabetes in Rural/Remote North Queensland, Australia: A Retrospective Cohort Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1242-P
Author(s):  
NISHA NANGRANI ◽  
USMAN MALABU ◽  
VENKAT VANGAVETI
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
The Impact

scholarly journals Organisational Factors Induce Prolonged Emergency Department Length of Stay in Elderly Patients – A Retrospective Cohort Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0135066 ◽  
Author(s):  
Steffie H. A. Brouns ◽  
Patricia M. Stassen ◽  
Suze L. E. Lambooij ◽  
Jeanne Dieleman ◽  
Irene T. P. Vanderfeesten ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Organisational Factors
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