Psychiatric hospitalizations in Brazil: exploratory and trend analysis from 2009 to 2019

ABSTRACT Objective: To examine the rates of psychiatric hospitalization and the average length of stay, in Brazil, from 2009 to 2019, according to sociodemographic variables and character of the hospitalization (elective or urgency). Methods: This is an ecological study, with data collected from the Hospital Information System of the Unified Health System (SIH/SUS). Hospital admission rates were described according to diagnosis, sex, and age group. Percentage variation and rate ratios were calculated. To evaluate the time series, the data were submitted to linear regression analysis. Results: The rate of hospitalization for mental disorders decreased from 14.2/10,000 in 2009 to 11.2 in 2019, with the most significant variation occurring between mental and behavioral disorders due to alcohol use. The men had about twice as many episodes as the women in all the years evaluated. Higher rates were found in the age group of 30 and 59 years. The length of stay also decreased in the period. Besides, the urgency character presented almost 82% of the total hospitalizations. Conclusions: There was a reduction in hospital admissions for mental disorders in the analyzed period, demonstrating the relevance of mental health care changes resulting from the Psychiatric Reform.

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272 Morbid Obesity in Lower Limb Arthroplasty: Short Length of Stay and Favourable One-Year Outcomes

British Journal of Surgery ◽

10.1093/bjs/znab134.543 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

M Sharrock ◽

A Nugur ◽

S Hossain

Keyword(s):

Morbid Obesity ◽

Length Of Stay ◽

Lower Limb ◽

Average Length ◽

Perioperative Complications ◽

Joint Infection ◽

Admission Rate ◽

Tendon Injury ◽

Morbidly Obese ◽

Admission Rates

Abstract Introduction There are concerns that BMI is associated with a greater length of stay (LOS) and perioperative complications in lower limb arthroplasty. Method We analysed data from a six-month period to see if there was a correlation between BMI and LOS. We performed a subgroup analysis for patients with morbid obesity (BMI >40). Results 285 TKRs and 195 THRs were analysed. For TKRs, the average length of stay was 2.7 days. There was no significant correlation between BMI and LOS (r=-0.0447, p = 0.2267). The morbidly obese category (n = 33) had the shortest LOS (2.5 days) compared to other BMI categories. 30-day readmission rate was 6%. 90-day re-admission rate was 12%. Six patients had minor wound issues requiring no intervention or antibiotics only. The was one prosthetic joint infection, one stitch abscess, one DVT and one patellar tendon injury. For THRs, the average LOS was 2.9 days. There was no significant correlation between BMI and LOS (r = 0.007, p = 0.4613). The morbid obese category (n = 9) had the shortest LOS (1.9 days) compared to other BMI categories. No patients were readmitted within 90 days or had documented complications. Conclusions Increased BMI is not associated with increased LOS. The morbidly obese had the shortest LOS, and commendable complication and re-admission rates.

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Abstract 1122‐000067: Radial Versus Femoral Artery Access for Mechanical Thrombectomy Following IV tPA Administration

Stroke: Vascular and Interventional Neurology ◽

10.1161/svin.01.suppl_1.000067 ◽

2021 ◽

Vol 1 (S1) ◽

Author(s):

Joshua S Catapano ◽

Andrew Ducruet ◽

Felipe C Albuquerque ◽

Ashutosh Jadhav

Keyword(s):

Length Of Stay ◽

Acute Stroke ◽

Mechanical Thrombectomy ◽

Average Length ◽

Linear Regression Analysis ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Access Site ◽

Femoral Access ◽

Iv Tpa

Introduction : The transradial artery (TRA) approach for neuroendovascular procedures has been demonstrated as a safe and effective alternative to the transfemoral artery (TFA) approach. The present study compares the efficiency and periprocedural outcomes of the TRA and TFA approach for acute stroke interventions in patients receiving intravenous alteplase. Methods : The study was designed as a retrospective analysis of patients who underwent acute mechanical thrombectomy at a large cerebrovascular center between January 2014 and March 2021. Intervention cohorts (TRA and TFA) were compared on baseline characteristics, periprocedural efficiency/efficacy, and in‐hospital outcomes. Results : A total of 314 patients underwent acute mechanical thrombectomy following IV tPA via TRA (6.7%, 21/314) or TFA (93.3%, 293/314) approach. The overall complication rate appeared higher in TFA (6.8%, 20/314) compared to TRA (4.8%,1/21) patients. Access site complications were present in 4.1%(12/293) of TFA patients and 0.0%(0/21) of TRA patients. The average length of stay (days ± standard deviation) was significantly greater in TFA (8.8 ± 8.5) vs. TRA (4.8 ± 2.9) patients (P = 0.02). Linear regression analysis found femoral access (p = 0.046), Medicaid (p = 0.004) insurance, and discharge NIHSS >10 (p = 0.045) as predictors of increased length of stay. However, when time to initial physical/occupation session was added to the model, access site was no longer significant. Conclusions : The TRA (vs. TFA) approach for acute stroke interventions following IV tPA administration may potentially reduce periprocedural complications and hospital length of stay. The reduction in length of stay with TRA access appears to be associated with earlier initiation of therapies.

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A study on length of stay and its predictors among dengue patients in a tertiary care institute in Lucknow

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20195071 ◽

2019 ◽

Vol 6 (11) ◽

pp. 4870

Author(s):

Sandhya Mishra ◽

Deepak Chopra ◽

Nidhi Jauhari ◽

Ausaf Ahmad

Keyword(s):

Occupational Exposure ◽

Length Of Stay ◽

Hospital Admissions ◽

Tertiary Care ◽

Case Fatality ◽

Length Of Hospital Stay ◽

Care Hospital ◽

Age Group ◽

Cross Sectional ◽

Early Arrival

Background: Dengue virus infection is a growing health problem and is prevalent throughout India. Research focusing on length of hospital stay and its predictors is scarce from India. This is important considering the burden of the disease during epidemics and impact on hospital admissions. Hence the study was conducted with the objectives to find out the factors influencing the length of stay in hospital of dengue patients.Methods: A cross sectional retrospective observational study conducted at a tertiary care hospital from August 2016 to October 2016. Data was retrieved from case sheets at Medical Record Department of 350 lab confirmed adult dengue patients admitted in the hospital.Results: The majority of patients admitted were of economically productive age group of 18-45 years and males indicating the occupational exposure to the vector of dengue. The study found that majority had length of stay of less than a week and as age increases the length of stay also increases (statistically significant). The nil case fatality and lesser number of mean days of symptoms before admission possibly indicate that early arrival of patients to hospital can lead to very low fatality rates. Further research required to find out the other predictors of length of stay.Conclusions: The study concludes that the dengue affects the economically productive age group and more males thereby indicating occupational exposure to the vector. The age of the patient can be used as an indicator to the length of stay in the hospital.

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Recent Critical Trends in Mental Hospital Admissions in the Oxford Region

Journal of Mental Science ◽

10.1192/bjp.108.452.59 ◽

1962 ◽

Vol 108 (452) ◽

pp. 59-67 ◽

Cited By ~ 3

Author(s):

A. Barr ◽

D. Golding ◽

R. W. Parnell

Keyword(s):

Mental Health ◽

Length Of Stay ◽

Mental Hospital ◽

Hospital Admissions ◽

Average Length ◽

Time Study ◽

Ministry Of Health ◽

Mental Hospitals ◽

Average Length Of Stay ◽

One Year

The statistics on mental hospitals published by the Ministry of Health (1957) show that the average length of stay for admissions to mental hospitals decreased in the period 1952–1956. According to the Registrar-General's Mental Health Supplement (1961) there was an average saving, between 1951 and 1958, of sixteen days for men and thirteen days for women, among patients staying less than one year. But these figures for stay only relate to the patients discharged each year, irrespective of the year of their admission, and furthermore we do not know what happens to particular groups such, for example, as schizophrenics. Although remarkable changes are occurring at the present time, study of them is hampered by lack of appropriate and up-to-date information.

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Musculoskeletal malignant neoplasms hospitalisation in Victoria

Journal of Epidemiological Research ◽

10.5430/jer.v1n1p33 ◽

2015 ◽

Vol 1 (1) ◽

pp. 33

Author(s):

Timothy Ore

Keyword(s):

Rural Communities ◽

Hospital Readmission ◽

Readmission Rate ◽

Hospital Admissions ◽

Average Length ◽

Malignant Neoplasms ◽

Factors Associated ◽

Admission Rates ◽

Average Length Of Stay ◽

Disability Support

The paper describes factors associated with 2,605 hospital admissions for musculoskeletal malignant neoplasms (MMN) over oneyear. The rates per 10,000 population increased significantly (t=5.3, p<.01) with age, with men (4.5 per 10,000 population, 95% CI 4.1-5.0) at greater risk than women (3.3 per 10,000 population, 95% CI 2.8-3.7). The 30-day readmission rate was 19%, thethird highest of all admission categories. The average length of stay was significantly (t=4.5, p<.01) shorter in the metropolitanarea (8.2 days) than in rural communities (10.8 days). The age-standardised rates varied inversely (r=-0.28) with socioeconomicstatus. Communities with high MMN admission rates had high rates of heart failure admissions (r=0.35), alcohol consumption(r=0.34) and receiving Disability Support Pension (r=0.32). There was a significant (t=13.8, p<.001) monthly variability inMMN hospitalisation rates. As a leading cause of hospital readmission and disability, the condition requires closer analysis.

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16 Comparison of Characteristics and Outcomes for Older Adults Admitted to Specialty Wards Versus Outlying Wards at Royal Bournemouth and Christchurch Hospitals

Age and Ageing ◽

10.1093/ageing/afz183.16 ◽

2020 ◽

Vol 49 (Supplement_1) ◽

pp. i1-i8

Author(s):

A Stafford ◽

A Martin ◽

D Tiwari

Keyword(s):

Length Of Stay ◽

Health Care Professionals ◽

Average Length ◽

Elderly Care ◽

Admission Rates ◽

Medical Needs ◽

Allied Health Care ◽

Average Length Of Stay ◽

Acute Medical Unit ◽

Dedicated Team

Abstract Background At Royal Bournemouth and Christchurch Hospitals (RBCH) elderly patients are admitted to either the acute medical unit or the older person’s assessment unit. If the inpatient stay is likely to be longer than 72 hours, then patients are transferred to one of three elderly care wards. If these wards are at capacity, then patients must be outlied to other wards. Introduction GMC guidance June 2014, states hospital inpatients should have a named consultant. Studies have shown that length of stay and outcomes can be affected when the patient is on an outlying ward. This issue affects many hospitals and specialties, and also impacts older frail patients at RBCH. During winter elderly care admission rates increase, and more patients are outlied. Our aim was to improve the care and outcomes for elderly care patients treated on outlying wards. Methods The notes of 50 specialty ward patients and 50 outlying patients were compared from the first two weeks of January and February 2019 using scanned electronic records where elderly care was responsible for their treatment. We studied demographic characteristics, length of stay, mortality, readmission within 30 days of discharge, frequency of consultant review, escalation plans, discharge destination and ward moves. Interventions A dedicated outlying team was created for the 2018/2019 winter to attempt to improve outcomes for outlying elderly care patients. This team consisted of a geriatrician, registrar, SHO and allied health care professionals including a physiotherapist and discharge coordinator. Results Our results showed that outlying patients had a significantly longer average length of stay compared to patients on specialty ward (13.8 days vs 8.2 days, p=0.01). A significantly higher proportion of patients in outlying wards did not have a consultant review every 72 hours (66% vs 8.3% specialty ward patients, p=0.001). However the specialty ward patients had a significantly higher number of readmissions within 30 days (30.6% vs 16%, p=0.04). Conclusions We found that despite a dedicated team, outlying patients had a significantly longer length of stay and were seen by a consultant less often than patients on a specialty ward. Further work is needed to ensure equality of care for these patients. Patients with complex medical needs are generally triaged to specialty wards, which may account for their higher readmission rate.

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A Thirty-Year Retrospective Study of Hospitalization among Severely Mentally III Patients

The Canadian Journal of Psychiatry ◽

10.1177/070674379403900206 ◽

1994 ◽

Vol 39 (2) ◽

pp. 95-102 ◽

Cited By ~ 2

Author(s):

Céline Mercier ◽

Claude Renaud ◽

Suzanne King

Keyword(s):

Retrospective Study ◽

Length Of Stay ◽

Psychiatric Hospitalization ◽

Average Length ◽

Process Of Change ◽

Average Length Of Stay ◽

Hospitalization Rates ◽

Disabled Patients ◽

One Year

This study examines the effects of deinstitutionalization policies on psychiatric hospitalization rates over a thirty-year period. It is based on a retrospective study of successive hospitalizations in severely disabled patients. The data indicate that in any five-year period these patients still spend over 20% of their time in hospital. For patients who have stayed for a total of more than one year every five years in hospital, the average length of stay has been decreasing far less rapidly in the last fifteen years than it had previously. Patients who were first admitted after 1971 spent proportionally as much time in hospital as those whose first stay was earlier. These results show that the groups primarily affected by deinstitutionalization are those who were first hospitalized prior to the 1970s and those who are the heaviest hospital users. However, the data from the patients admitted since the seventies seem to reveal that the process of change may have reached its limits.

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A closer look at the epidemiology of schizophrenia and common mental disorders in Brazil

Dementia & Neuropsychologia ◽

10.1590/1980-57642020dn14-030009 ◽

2020 ◽

Vol 14 (3) ◽

pp. 283-289

Author(s):

Randhall Bruce Carteri ◽

Jean Pierre Oses ◽

Taiane de Azevedo Cardoso ◽

Fernanda Pedrotti Moreira ◽

Karen Jansen ◽

...

Keyword(s):

Mental Disorders ◽

Health System ◽

Hospital Admissions ◽

Common Mental Disorders ◽

Age Groups ◽

Epidemiologic Studies ◽

Emerging Countries ◽

Unified Health System ◽

Hospital Expenses ◽

The Impact

ABSTRACT. Schizophrenia and common mental disorders are noteworthy social and economic concern worldwide. Epidemiologic studies on the impact of specific mental disorders in emerging countries are scarce. Objectives: We aimed to characterize the demographic, social, and economic burden of schizophrenia and common mental disorders patients in the health system in Brazil. Methods: Data on these conditions in Brazil between 2008 and 2019 were collected through the website of the Departamento de Informática do Sistema Único de Saúde (Information Technology Department of the Unified Health System - DATASUS) maintained by the Brazilian Ministry of Health. Mean annual hospital admissions were 154,009.67, and cumulative incidence of 77.44 admissions per 100,000 inhabitants. Results: Average annual hospital expenses were US$ 67,216,056.04, with an average admission cost of US$ 432.58. The most affected age groups were older adults albeit younger individuals showed a trend towards increase of occurrences in recent years. There were a higher number of admissions in men compared to women. Conclusions: We consider the results obtained important to assist in evaluating and guiding public policies regarding the prevention and treatment in health systems.

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The challenge of using routinely collected data to compare hospital admission rates by ethnic group: a demonstration project in Scotland

Journal of Public Health ◽

10.1093/pubmed/fdz175 ◽

2019 ◽

Vol 42 (4) ◽

pp. 748-755 ◽

Cited By ~ 2

Author(s):

S Knox ◽

R S Bhopal ◽

C S Thomson ◽

A Millard ◽

A Fraser ◽

...

Keyword(s):

Hospital Admission ◽

Ethnic Group ◽

Ethnic Groups ◽

Hospital Admissions ◽

Heart Diseases ◽

Equity In Health ◽

Admission Rates ◽

Group A ◽

Rate Ratios ◽

Equity In Health Care

Abstract Background Recording patients’ ethnic group supports efforts to achieve equity in health care provision. Before the Equality Act (2010), recording ethnic group at hospital admission was poor in Scotland but has improved subsequently. We describe the first analysis of the utility of such data nationally for monitoring ethnic variation. Methods We analysed all in-patient or day case hospital admissions in 2013. We imputed missing data using the most recent ethnic group recorded for a patient from 2009 to 2015. For episodes lacking an ethnic code, we attributed known ethnic codes proportionately. Using the 2011 Census population, we calculated rates and rate ratios for all-cause admissions and ischaemic heart diseases (IHDs) directly standardized for age. Results Imputation reduced missing ethnic group codes from 24 to 15% and proportionate redistribution to zero. While some rates for both all-cause and IHD admissions appeared plausible, unexpectedly low or high rates were observed for several ethnic groups particularly amongst White groups and newly coded groups. Conclusions Completeness of ethnicity recoding on hospital admission records has improved markedly since 2010. However the validity of admission rates based on these data is variable across ethnic groups and further improvements are required to support monitoring of inequality.

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Impact of a community-based cardiovascular disease service intervention in a highly deprived area

Heart ◽

10.1136/heartjnl-2019-315047 ◽

2019 ◽

Vol 106 (5) ◽

pp. 374-379 ◽

Cited By ~ 2

Author(s):

Jennifer Downing ◽

Tanith C Rose ◽

Pooja Saini ◽

Bashir Matata ◽

Zoe McIntosh ◽

...

Keyword(s):

Cardiovascular Disease ◽

Length Of Stay ◽

Hospital Admissions ◽

Controlled Study ◽

Rehabilitation Service ◽

Control Group ◽

Community Based ◽

Emergency Hospital ◽

Admission Rates ◽

Emergency Hospital Admissions

ObjectiveTo examine the effects on emergency hospital admissions, length of stay and emergency re-admissions of providing a consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service, based in a highly deprived area in the North West of England.MethodsA longitudinal matched controlled study using difference-in-differences analysis compared the change in outcomes in the intervention population, to the change in outcomes in a matched comparison population that had not received the intervention, 5 years before and after implementation. The outcomes were emergency hospitalisations, length of inpatient stay and re-admission rates for cardiovascular disease (CVD).ResultsFindings show that the intervention was associated with 66 fewer emergency CVD admissions per 100 000 population per year (95% CI 22.13 to 108.98) in the post-intervention period, relative to the control group. No significant measurable effects on length of stay or emergency re-admission rates were observed.ConclusionThis consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service was associated with a lower rate of emergency hospital admissions in a highly disadvantaged population. Similar approaches could be an effective component of strategies to reduce unplanned hospital admissions.

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