Total Population Estimate of Newborn Special-Care Bed Needs

PEDIATRICS ◽  
1985 ◽  
Vol 75 (6) ◽  
pp. 993-996
Author(s):  
August L. Jung ◽  
Nan Sherman Streeter
Keyword(s):  
Length Of Stay ◽  
Total Population ◽  
Average Length ◽  
Special Care ◽  
Care Hospital ◽  
Total Hospital ◽  
Live Births ◽  
Average Length Of Stay ◽  
Study Results ◽  
Hospital Days

In 1977, 7% of the 38,855 infants born in Utah were estimated to have required a total of 27,439 special-care hospital days. About half (53%) were mildly ill; their average length of stay was 4.6 days, or 24% of the total hospital-days. Another 20% of the infants had intermediate illness, with a 12-day average stay, or 23% of the total hospital-days. The remaining 27% of the infants required intensive care and used 53% of the total hospital-days; their average length of stay was 20 days. As a total population, the state's 38,855 births generated a need for two beds per 1,000 annual live births in special-care facilities. The estimated bed need was: mild illness (Level I), 0.5 beds per 1,000 annual live births; intermediate illness (Level II), 0.5 beds per 1,000 annual live births; and intense illness (Level III), one bed per 1,000 annual live births. Results are based on the assumption that nonstudy births, 30% of the total, have needs proportionate to study births. The following considerations are necessary to extrapolate these bed needs to other populations: (1) convalescence of intensely ill babies may require that up to 50% of their bed needs may be shifted to intermediate care; (2) compliance with criteria for transport to the next level of care may not be 100% as assumed in the study, thus redistributing bed needs; (3) census characteristically fluctuates in special-care nurseries (study results are reported for an unchanging daily census); and (4) the low birth rate of a population is intimately related to the bed needs.

scholarly journals Temporal Changes in Central-Line–Associated Bloodstream Infection Time Between Events, 2017–2018 Versus 2015–2016

2020 ◽  
Vol 41 (S1) ◽  
pp. s403-s404
Author(s):  
Jonathan Edwards ◽  
Katherine Allen-Bridson ◽  
Daniel Pollock
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Average Length ◽  
Bloodstream Infections ◽  
Central Line ◽  
Significant Shift ◽  
Care Hospital ◽  
Average Length Of Stay ◽  
Period 2 ◽  
Hospital Bed

Background: The CDC NHSN surveillance coverage includes central-line–associated bloodstream infections (CLABSIs) in acute-care hospital intensive care units (ICUs) and select patient-care wards across all 50 states. This surveillance enables the use of CLABSI data to measure time between events (TBE) as a potential metric to complement traditional incidence measures such as the standardized infection ratio and prevention progress. Methods: The TBEs were calculated using 37,705 CLABSI events reported to the NHSN during 2015–2018 from medical, medical-surgical, and surgical ICUs as well as patient-care wards. The CLABSI TBE data were combined into 2 separate pairs of consecutive years of data for comparison, namely, 2015–2016 (period 1) and 2017–2018 (period 2). To reduce the length bias, CLABSI TBEs were truncated for period 2 at the maximum for period 1; thereby, 1,292 CLABSI events were excluded. The medians of the CLABSI TBE distributions were compared over the 2 periods for each patient care location. Quantile regression models stratified by location were used to account for factors independently associated with CLABSI TBE, such as hospital bed size and average length of stay, and were used to measure the adjusted shift in median CLABSI TBE. Results: The unadjusted median CLABSI TBE shifted significantly from period 1 to period 2 for the patient care locations studied. The shift ranged from 20 to 75.5 days, all with 95% CIs ranging from 10.2 to 32.8, respectively, and P < .0001 (Fig. 1). Accounting for independent associations of CLABSI TBE with hospital bed size and average length of stay, the adjusted shift in median CLABSI TBE remained significant for each patient care location that was reduced by ∼15% (Table 1). Conclusions: Differences in the unadjusted median CLABSI TBE between period 1 and period 2 for all patient care locations demonstrate the feasibility of using TBE for setting benchmarks and tracking prevention progress. Furthermore, after adjusting for hospital bed size and average length of stay, a significant shift in the median CLABSI TBE persisted among all patient care locations, indicating that differences in patient populations alone likely do not account for differences in TBE. These findings regarding CLABSI TBEs warrant further exploration of potential shifts at additional quantiles, which would provide additional evidence that TBE is a metric that can be used for setting benchmarks and can serve as a signal of CLABSI prevention progress.Funding: NoneDisclosures: None

Abstract 368: Association of Atrial Fibrillation with In-hospital Outcomes in ST-Elevation Myocardial Infarction - A Propensity Matched Study

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Prakash Harikrishnan ◽  
Marjan Mujib ◽  
Tanush Gupta ◽  
Dhaval Kolte ◽  
Chandrasekar Palaniswamy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Average Length ◽  
St Elevation Myocardial Infarction ◽  
Hospital Charges ◽  
Total Hospital ◽  
Average Length Of Stay ◽  
St Elevation

Background: Atrial fibrillation is a relatively common comorbid condition in patients with coronary artery disease. However, there are limited data on the association of atrial fibrillation (AF) with outcomes in ST-elevation myocardial infarction (STEMI). Methods: We queried the 2003-2011 Nationwide Inpatient Sample databases using the ICD-9 diagnosis codes, to identify all patients > 18 years admitted with a primary diagnosis of STEMI. We studied the association of AF with in-hospital outcomes in these patients both by regression analysis and propensity match to adjust for demographics, hospital characteristics and co-morbidities. Results: Of the total 452,772 (64.5% men) STEMI hospitalizations, AF was documented in 58,273 (12.9%) cases. Patients with AF were older (mean age 75±12 vs 64±14 years; p<0.001) and had a higher proportion of women (42.5% vs 34.5%; p<0.001) than patients without AF. STEMI patients with AF had a higher risk-adjusted in-hospital mortality (OR 1.15, 95% CI 1.12-1.19, p<0.001), longer average length of stay (7 days vs 4 days, P<0.001) and higher average total hospital charges ($74,082 vs $57,331, P<0.001) than those without AF. Using propensity matching, 57,388 STEMI patients with AF were compared with the same number of patients without AF. Within these matched cohorts, STEMI patients with AF had higher in-hospital mortality (16.7% vs 15.1%, OR 1.13, 95% CI 1.09-1.16; p<0.001), longer average length of stay (7 days vs 6 days, P<0.001), and higher average total hospital charges ($73,832 vs $65,201, P<0.001) than patients without AF. Conclusions: In patients hospitalized with STEMI, AF was independently associated with modestly higher in-hospital mortality, higher hospital charges, and longer length of stay.

scholarly journals Percent Bed occupancy rate in a selected specialized tertiary care hospital in Dhaka city

1970 ◽  
Vol 11 (1) ◽  
pp. 18-24 ◽  
Author(s):  
H Rahman ◽  
SME Haque ◽  
MA Hafiz
Keyword(s):  
Length Of Stay ◽  
Tertiary Care Hospital ◽  
Average Length ◽  
Tertiary Care ◽  
Calculated Data ◽  
Care Hospital ◽  
Dhaka City ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay

Background and Aims: Providing a necessary care for a sick person outside home 'in hospes or hospital' dates back to nearly 300 century BC. In the present day hospital care facilities has been taken an institutional shape both in public and private sector. A hospital bed is both a scarce and expensive commodity in healthcare. Administrators running hospitals are in a dire need of objective measures and methods for efficient management of their limited financial resources. Bed utilization rates can be of immense help in realistic and effective decision making. The present study was undertaken to explore utilization of bed in a specialized tertiary care hospital in the Dhaka city. Methods: Hospital records of the year were reviewed- age, gender, disease profile, duration of hospital stay, outcome of treatment were recorded and bed occupancy rate was calculated. Data were presented as number, percentage and/ or mean SD, as appropriate. The dada were managed by Statistical Package for Social Science (SPSS) for Windows Version 10. Results: The results showed in the year 2001 total number of admissions were 13,305 of which 9953 (74.8%) were male and 3352 (25.2%) female. Average monthly admission was 1109. Maximum number of admissions (1304) was observed in the month of September of that year. Male admission rate was higher than female admission throughout the year. Among all the admission 27.2% were of road traffic accident cases. Among the admitted patients there was 57.3% discharge with advice, 1.9% death, 14.6% discharge on request bond, 12.7% discharge on request. Of all the admission there 12.5% found to be absconded. Bed occupancy rate was 79.75% and average length of stay in the hospital 18.47 days. Conclusions: The present data suggest that (i) in terms of bed occupancy rate the NITOR found to run in optimal capacity which, however, might be attributed to the relative high rate of ascendance and discharges on requests; (ii) average length of stay of patients appeared to be relatively longer and (iii) the management need to look into the issue and take appropriate measures to reduce patients unwanted long duration of stay and make the tertiary care hospital improve the quality of services. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9817 BJMS 2012; 11(1): 18-24

scholarly journals Factors Affecting the Length of Stay in the Intensive Care Unit: Our Clinical Experience

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mehmet Toptas ◽  
Nilay Sengul Samanci ◽  
İbrahim Akkoc ◽  
Esma Yucetas ◽  
Egemen Cebeci ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Average Length ◽  
Cerebrovascular Diseases ◽  
Factors Affecting ◽  
Average Length Of Stay ◽  
Lengths Of Stay ◽  
Life Threatening ◽  
Hospital Days

Background and Aim. Long hospital days in intensive care unit (ICU) due to life-threatening diseases are increasing in the world. The primary goal in ICU is to decrease length of stay in order to improve the quality of medical care and reduce cost. The aim of our study is to identify and categorize the factors associated with prolonged stays in ICU.Materials and Method. We retrospectively analyzed 3925 patients. We obtained the patients’ demographic, clinical, diagnostic, and physiologic variables; mortality; lengths of stay by examining the intensive care unit database records.Results. The mean age of the study was 61.6 ± 18.9 years. The average length of stay in intensive care unit was 10.2 ± 25.2 days. The most common cause of hospitalization was because of multiple diseases (19.5%). The length of stay was positively correlated with urea, creatinine, and sodium. It was negatively correlated with uric acid and hematocrit levels. Length of stay was significantly higher in patients not operated on than in patients operated on (p<0.001).Conclusion. Our study showed a significantly increased length of stay in patients with cardiovascular system diseases, multiple diseases, nervous system diseases, and cerebrovascular diseases. Moreover we showed that when urea, creatinine, and sodium values increase, in parallel the length of stay increases.

scholarly journals Average length of stay in Level III and IV Care of Accident and Emergency Department of Tertiary care Hospital

JMS SKIMS ◽  
2011 ◽  
Vol 14 (2) ◽  
pp. 61-62
Author(s):  
Reyaz A Rangrez ◽  
Sheikh Mushtaq ◽  
Shafa Deva ◽  
Tanveer A Rather ◽  
Sameena Mufti ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Tertiary Care ◽  
Care Hospital ◽  
Emergency Admissions ◽  
Prolonged Length ◽  
Average Length Of Stay ◽  
Accident And Emergency ◽  
Time Gap

BACKGROUND: The scope of Accident and Emergency (A&E) Department is gradually broadening and in fact these are now becoming“mini hospitals within hospitals”.OBJECTIVE:To determine the average length of stay (LOS) in level III and level IV care and factors leading to prolonged length of stay.METHODS:A Hospital based study with follow up of patients received in level III and level IV of A&E Department and the patients were followed till transfer out to respective specialty wards,discharge or death.RESULTS: Emergency beds occupied 9.3% of the total hospital bed strength. Of the total emergency admissions studied, 71.1 % comprised of neurosurgical admissions followed by CVTS (21.4%), neurological (6.8%) and other admissions(1.2%). The average Length of Stay was greatest in CVTS followed by General Surgery i.e. 5.4 days and 4.6 days respectively. The time gap between investigations ordered and reports received was 1.04 days. 67% of the patients who attended A&E Department were of rural background and out of it 54% have read upto high school.CONCLUSIONS: Average Length of stay is 4.3 days which needs to be brought down to 24 hours as per international norms to provide equitable emergency care to wider population. Co-ordination between administration and cliniciansis needed to expedite theproblem.JMS2011;14(2):61-62

Comprehensive Asthma Care Reduces Hospitalization

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 542-543
Author(s):  
THOMAS F. PLAUT
Keyword(s):  
Length Of Stay ◽  
Learning Process ◽  
Average Length ◽  
Computer Game ◽  
Asthma Care ◽  
Average Length Of Stay ◽  
National Rate ◽  
Hospital Days

To the Editor.— Rubin et al1 devised a computer game to convey asthma information to children 7 to 12 years of age. They did not include parents in the learning process. They express surprise that the children's increased knowledge did not lead to a decrease in hospital days due to asthma. We are not surprised. In 1984, our patients with asthma were hospitalized at 31% of the national rate. We admitted at a rate of 1.3/1,000 and had an average length of stay of 2.5 days.

Abstract 3524: Implementation of the American Heart Association Get With the Guidelines Heart Failure Program (GWTG-HF) Reduces Length of Stay and Decreases Cost for Hospitalized Heart Failure Patients at St. Joseph’s Regional Medical Center (SJRMC)

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Robert T Faillace ◽  
Richard B Siegrist ◽  
Steven Duchensky ◽  
Lorraine Marut ◽  
Ilene Matza ◽  
...  
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Direct Cost ◽  
Average Length ◽  
Standards Of Care ◽  
Contribution Margin ◽  
Heart Failure Patients ◽  
Average Length Of Stay ◽  
Hospital Days ◽  
Multi Disciplinary Team

Hospitalized heart failure patients (HF) may not consistently receive standards of care and hospitals frequently realize a financial loss in the care of HF patients. GWTG-HF makes it more likely to ensure optimal care, decrease direct cost and increase hospital profit in the management of HF patients. HYPOTHESIS: Utilization of GWTG-HF with a multi-disciplinary team would be associated with a consistent application of standards of care, shorter duration of hospitalization and less direct cost for hospitalized HF patients. METHODS: GWTG-HF was fully operational in 2006 with a multi-disciplinary team consisting of a Physician Champion, Advanced Practice Nurses (APNs), Case Managers and RNs. APNs utilized GWTG-HF at the point of service and worked collaboratively with attending physicians. We compared the average length of stay, total number of hospitalized days, patient revenue, total direct cost, contribution margin, and the profit/loss for hospitalized HF patients in 2005 to those in 2006. RESULTS: There were 773 cases of HF admissions in 2005 as compared to 781 in 2006. Overall compliance with GWTG-HF Core Measures in 2006 was 98% (HF-1 D/C Instructions 99%; HF-2 Left ventricular systolic (LVS) function evaluation 96%; HF-3 ACEI/ARB for LVS dysfunction 98%; HF-4 Smoking cessation advice 100%; Beta Blocker Use 95%). The average length of stay (LOS) in 2005 was 6.7 days as compared to 6.3 days in 2006 (p <0.02). The total number of hospital days in 2005 was 5,145 as compared to 4,880 in 2006 (p<0.02). Between 2005 and 2006 patient revenue increased by $279,847 (p<0.01), direct cost decreased by $348,014 (p<0.05), contribution margin increased by $627,861 (p=0.06) and the full cost profit margin increased by $309,460 (NS). CONCLUSION: Utilization of GWTG-HF at SJRMC is associated with a high compliance with standards of hospitalized HF care, decrease in average LOS, decrease in total number of hospital days and decrease in direct cost. Although not statistically significant, hospital contribution margin and profit increased for acutely decompensated HF patients.

scholarly journals Impact of vaccination in reducing Hospital expenses, Mortality and Average length of stay among COVID 19 patients. A retrospective cohort study from India

2021 ◽  
Author(s):  
Madhumathi Ramakrishnan ◽  
Prakash Subbarayan
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Length Of Stay ◽  
Retrospective Cohort ◽  
Relative Risk Reduction ◽  
Average Length ◽  
Total Hospital ◽  
Average Length Of Stay ◽  
The Mean ◽  
Hospital Expenses

Background & Aim: WHO listed vaccine hesitancy among the top 10 global threats to health and there are very few reports highlighting vaccine benefits against COVID-19. The aim of this study was to study the impact of vaccination on reducing the average length of stay (ALOS), intensive care unit (ICU) requirement, mortality and cost of the treatment among COVID-19 patients. Methods: In this retrospective cohort study all the patients above 45 years who underwent treatment for COVID-19 were included. The data of patients treated pan India during the period March & April 2021 with the diagnosis of COVID-19, under health insurance cover, were extracted to study parameters like the ALOS, mortality, ICU requirement, total hospital expenses incurred and the vaccination status. Results: Among 3820 patients with COVID-19, 3301 (86.4%) were unvaccinated while 519 (13.6%) were vaccinated. Among the unvaccinated the mean (s.d) ALOS was 7 days. Fourteen days after second dose of vaccination this was significantly less (p=0.01) at 4.9. The mean total hospital expense among the unvaccinated was Rs. 277850. Fourteen days after second dose of vaccination this was further less (p=0.001) at Rs. 217850. Among the unvaccinated population 291/3301 (8.8%) required ICU and this was significantly less (p=0.03) at 31/519 (6%) among the vaccinated. Among those who received two doses of vaccination it was further less at 1/33 (3%). The mortality among unvaccinated patients was 16/3301 (0.5%) while there was no mortality among the vaccinated. Among those who received two doses of vaccination there was a 66% relative risk reduction in ICU stay and 81% relative risk reduction in mortality. Conclusions: There was a significant reduction in ALOS, ICU requirement, mortality & treatment cost in patients who had completed two doses of vaccination. These findings may be used in motivating public and promoting vaccination drive.

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

scholarly journals Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathanael Lapidus ◽  
Xianlong Zhou ◽  
Fabrice Carrat ◽  
Bruno Riou ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Average Length ◽  
Parametric Method ◽  
Estimation Methods ◽  
Unbiased Estimation ◽  
Bed Occupancy ◽  
Average Length Of Stay ◽  
Discharged Patients ◽  
First Admission

Abstract Background The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS estimate of infected patients is critical to accurately parameterize models examining mitigation and preparedness scenarios. Methods Two estimation methods of ICU_ALOS were compared: the average LOS of already discharged patients at the date of estimation (DPE), and a standard parametric method used for analyzing time-to-event data which fits a given distribution to observed data and includes the censored stays of patients still treated in the ICU at the date of estimation (CPE). Methods were compared on a series of all COVID-19 consecutive cases (n = 59) admitted in an ICU devoted to such patients. At the last follow-up date, 99 days after the first admission, all patients but one had been discharged. A simulation study investigated the generalizability of the methods' patterns. CPE and DPE estimates were also compared to COVID-19 estimates reported to date. Results LOS ≥ 30 days concerned 14 out of the 59 patients (24%), including 8 of the 21 deaths observed. Two months after the first admission, 38 (64%) patients had been discharged, with corresponding DPE and CPE estimates of ICU_ALOS (95% CI) at 13.0 days (10.4–15.6) and 23.1 days (18.1–29.7), respectively. Series' true ICU_ALOS was greater than 21 days, well above reported estimates to date. Conclusions Discharges of short stays are more likely observed earlier during the course of an outbreak. Cautious unbiased ICU_ALOS estimates suggest parameterizing a higher burden of ICU bed occupancy than that adopted to date in COVID-19 forecasting models. Funding Support by the National Natural Science Foundation of China (81900097 to Dr. Zhou) and the Emergency Response Project of Hubei Science and Technology Department (2020FCA023 to Pr. Zhao).

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