scholarly journals Prolonged length of stay associated with air leak following pulmonary resection has a negative impact on hospital margin [Erratum]

2016 ◽  
Vol Volume 8 ◽  
pp. 351-352 ◽  
Author(s):  
Douglas Wood ◽  
Lisa Lauer ◽  
Andrew Layton ◽  
Kuo Tong
Author(s):  
Amelia E. Schlak ◽  
Linda H. Aiken ◽  
Jesse Chittams ◽  
Lusine Poghosyan ◽  
Matthew McHugh

Background: Burnout remains a persistent issue affecting nurses across the US health system. Limited evidence exists about the direct impact of nurse burnout on patient outcomes. This study explores the relationship between nurse burnout and mortality, failure to rescue, and length of stay, while also considering the effect of a good work environment. Methods: Cross sectional data from nurses and hospitals were used in conjunction with patient claims data. Multivariate logistic regression was used to study the relationship between nurse burnout, patient outcomes, the work environment, and Magnet status. Results: Higher odds of patient mortality, failure to rescue, and prolonged length of stay were found in hospitals that had, on average, higher nurse burnout scores. Good work environments were found to attenuate the relationship between nurse burnout and mortality, failure to rescue, and length of stay. Magnet status, another indicator of a good work environment, was found to attenuate the relationship between nurse burnout and mortality and failure to rescue. Conclusions: Improving the work environment remains a solution for hospitals looking to concurrently improve nurse burnout and patient outcomes. Administrators may look to the Magnet recognition program as a blueprint to better support nurses in providing safe, high quality care.


2021 ◽  
pp. 102490792110009
Author(s):  
Howard Tat Chun Chan ◽  
Ling Yan Leung ◽  
Alex Kwok Keung Law ◽  
Chi Hung Cheng ◽  
Colin A Graham

Background: Acute pyelonephritis is a bacterial infection of the upper urinary tract. Patients can be admitted to a variety of wards for treatment. However, at the Prince of Wales Hospital in Hong Kong, they are managed initially in the emergency medicine ward. The aim of the study is to identify the risk factors that are associated with a prolonged hospital length of stay. Methods: This was a retrospective cohort study conducted in Prince of Wales Hospital. The study recruited patients who were admitted to the emergency medicine ward between 1 January 2014 and 31 December 2017. These patients presented with clinical features of pyelonephritis, received antibiotic treatment and had a discharge diagnosis of pyelonephritis. The length of stay was measured and any length of stay over 72 h was considered to be prolonged. Results: There were 271 patients admitted to the emergency medicine ward, and 118 (44%) had a prolonged hospital length of stay. Univariate and multivariate analyses showed that the only statistically significant predictor of prolonged length of stay was a raised C-reactive protein (odds ratio 1.01; 95% confidence 1.01–1.02; p < 0.0001). Out of 271 patients, 261 received antibiotics in the emergency department. All 10 patients (8.5%) who did not receive antibiotics in emergency department had a prolonged length of stay (p = 0.0002). Conclusion: In this series of acute pyelonephritis treated in the emergency medicine ward, raised C-reactive protein levels were predictive for prolonged length of stay. Patients who did not receive antibiotics in the emergency department prior to emergency medicine ward admission had prolonged length of stay.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S V Valente de Almeida ◽  
H Ghattas ◽  
G Paolucci ◽  
A Seita

Abstract We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare. The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider. After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient. We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making. Key messages We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.


2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Sarah Psutka ◽  
Stephen Boorjian ◽  
Suzanne Stewart ◽  
Prabin Thapa ◽  
Robert Tarrell ◽  
...  

2015 ◽  
Vol 5 (9) ◽  
pp. 461-473 ◽  
Author(s):  
S. V. Kaiser ◽  
L.-A. Bakel ◽  
M. J. Okumura ◽  
A. D. Auerbach ◽  
J. Rosenthal ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Erica M. Jones ◽  
Amelia K. Boehme ◽  
Aimee Aysenne ◽  
Tiffany Chang ◽  
Karen C. Albright ◽  
...  

Objectives. Extended time in the emergency department (ED) has been related to adverse outcomes among stroke patients. We examined the associations of ED nursing shift change (SC) and length of stay in the ED with outcomes in patients with intracerebral hemorrhage (ICH). Methods. Data were collected on all spontaneous ICH patients admitted to our stroke center from 7/1/08–6/30/12. Outcomes (frequency of pneumonia, modified Rankin Scale (mRS) score at discharge, NIHSS score at discharge, and mortality rate) were compared based on shift change experience and length of stay (LOS) dichotomized at 5 hours after arrival. Results. Of the 162 patients included, 60 (37.0%) were present in the ED during a SC. The frequency of pneumonia was similar in the two groups. Exposure to an ED SC was not a significant independent predictor of any outcome. LOS in the ED ≥5 hours was a significant independent predictor of discharge mRS 4–6 (OR 3.638, 95% CI 1.531–8.645, and P = 0.0034) and discharge NIHSS (OR 3.049, 95% CI 1.491–6.236, and P = 0.0023) but not death. Conclusions. Our study found no association between nursing SC and adverse outcome in patients with ICH but confirms the prior finding of worsened outcome after prolonged length of stay in the ED.


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