Casemix and Affective Disorders: A Comparison of Private and Public Psychiatric Systems

1996 ◽  
Vol 30 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Robert D. Goldney ◽  
Penny Kent ◽  
Robert H. Elzinga
Keyword(s):  
Length Of Stay ◽  
Affective Disorders ◽  
Average Length ◽  
South Australia ◽  
Psychiatric Hospitals ◽  
Diagnosis Related Group ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Private And Public ◽  
Related Group

Objective: To determine whether there is a difference in length of stay for patients with affective disorders between private and public psychiatric hospitals. Method: The casemix Australian national diagnosis-related group (AN-DRG) diagnoses of all inpatient separations from private and public psychiatric hospitals in South Australia for 1 year were abstracted from records. The average length of stay for patients with affective disorders was calculated. Results: There was no significant difference in the average length of stay for patients with affective disorders treated in private and public psychiatric hospitals. Conclusions: These results should allay fears that the treatment of patients with affective disorders in any particular treatment setting will be compromised by the introduction of casemix.

scholarly journals Efficacy of a triage system to reduce length of hospital stay

2014 ◽  
Vol 204 (6) ◽  
pp. 480-485 ◽  
Author(s):  
P. Williams ◽  
E. Csipke ◽  
D. Rose ◽  
L. Koeser ◽  
P. McCrone ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Triage System ◽  
Traditional System ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Two Systems ◽  
Admission System ◽  
Novel Method

BackgroundAttempts have been made to improve the efficiency of in-patient acute care. A novel method has been the development of a ‘triage system’ in which patients are assessed on admission to develop plans for discharge or transfer to an in-patient ward.AimsTo compare a triage admission system with a traditional system.MethodLength of stay and readmission data for all admissions in a 1-year period between the two systems were compared using the participating trust's anonymised records.ResultsDespite reduced length of stay on the actual triage ward, the average length of stay was not reduced and the triage system did not lead to a greater number of readmissions. There was no significant difference in costs between the two systems.ConclusionsBased on our findings we cannot conclude that the triage system reduced length of stay, but we can conclude that it does not increase the number of readmissions as some have feared.

scholarly journals Economic impact of the Swiss Diagnosis-Related Group system on acute neurorehabilitation

2021 ◽  
Vol 10 (4) ◽  
pp. 10
Author(s):  
Loric Berney ◽  
Fabio Agri ◽  
Jean-Michel Pignat ◽  
Jean-Blaise Wasserfallen ◽  
Karin Diserens
Keyword(s):  
Economic Impact ◽  
Negative Impact ◽  
Average Length ◽  
Diagnosis Related Group ◽  
University Hospital ◽  
Accounting System ◽  
Financing System ◽  
Average Length Of Stay ◽  
Assessment Period ◽  
Related Group

Objective: To assess the economic impact of introducing the Swiss Diagnosis-Related Group (DRG)-financing system on the Acute Neurorehabilitation Unit (ANRU) of a University hospital in 2012 and to discuss the implications in 2020.Methods: A retrospective study using monocentric patient cohort and collecting anonymized data of consecutive patients admitted to the ANRU in 2012 and 2013. The characteristics, DRG A43Z, costs and revenues were retrieved from the hospital accounting system and allowed a comparison between the 2012 and 2013 groups of patients.Results: Forty-seven patients were included over the assessment period. In 2012, of the 23 patients admitted, 20 were coded A43Z, while in 2013, out of the 24 admissions, only eight had that specific code (p < .01). The average length of stay (LOS) increased from 45.5 days in 2012 to 49.5 days in 2013. Similarly, the average cost per patient increased by Swiss Franc (CHF) 19,994 over the two years, from CHF 183,634 in 2012 to CHF 194,629 in 2013. Finally, the average reimbursement per patient diminished by CHF 11,392, from CHF 193,153 in 2012 to CHF 181,760 in 2013.Conclusions: The negative impact on the cost–revenue balance is linked to both the increased cost of a longer stay and the decreased revenue due to less patients being coded A43Z. This study highlights the difficulties to justify funding of the complex care needed and to properly reflect patient burden in medico-administrative documents. Certainly, there is a need for a concerted effort to identify the services and resources needed within the DRG-system to guarantee the optimal management of acute neurorehabilitation.

Associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and type of admission

2017 ◽  
Vol 41 (S1) ◽  
pp. s901-s901
Author(s):  
J. Beezhold ◽  
U. Farooq ◽  
J. Isaac ◽  
A. Shepherd
Keyword(s):  
Length Of Stay ◽  
Gender Bias ◽  
Legal Status ◽  
Average Length ◽  
Psychiatric Inpatient ◽  
Published Data ◽  
Psychiatric Admission ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Competing Interest

IntroductionThere is little published data regarding the association between gender and outcomes in acute inpatient psychiatry. We present outcomes from a study of 5601 acute psychiatric admissions.ObjectiveThe objective of this study was to identify associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and at whether they were detained in hospital.MethodsThe relationship between gender and acute psychiatric inpatient length of stay and detention status was analyzed for all admissions over 90 months from Sept 2002 to Feb 2010. There were 5601 consecutive admissions included in this study, 2862 of which were male and 2739 were female. There were no exclusions. Data was complete for more than 99% of subjects, and was extracted from part of routine service data on an anonymous- basis. The subjects were admitted into two acute inpatient wards in central Norfolk. Data was analyzed using SPSS. Ethics consent was granted by the research ethics committee.ResultsThe study showed no significant difference in average length of stay (female = 32.98, male = 32.11; P = 0.595). Additionally, no significant difference was found linking gender to detention status (26% female, 25% male; P = 0.517) as opposed to informal or voluntary admission.ConclusionThe study found no evidence of a gender bias regarding overall length of stay and legal status in acute admissions. Further research should be conducted in this area to examine whether there is any gender bias in outcomes relating to diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Goal-Directed Achievement Through Geographic Location (GAGL) Reduces Patient Length of Stay and Adverse Events

2019 ◽  
Vol 35 (4) ◽  
pp. 323-329
Author(s):  
Michael J. Maniaci ◽  
Nancy L. Dawson ◽  
Jennifer B. Cowart ◽  
Eugene M. Richie ◽  
Anil G. Suryaprasad ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Geographic Location ◽  
Average Length Of Stay ◽  
Nutrition Services ◽  
Code Blue ◽  
Significant Difference ◽  
Multidisciplinary Rounds ◽  
Improve Hospital ◽  
Study Unit

This prospective cohort study aimed to improve hospital outcomes through geographic location of hospitalist patients and conducting daily multidisciplinary team rounds—Goal-directed Achievements through Geographic Location (GAGL). Patients were admitted to a geographic (GAGL) study unit where daily multidisciplinary rounds took place among nursing, case management, a hospitalist, pharmacy, physical and occupational therapy, respiratory therapy, and nutrition services. A total of 985 (56.4%) patients were admitted to the GAGL study unit and 760 patients (43.6%) were admitted to non-GAGL units. Patients admitted to the GAGL study unit had a shorter average length of stay (3.64 days vs 4.35 days, P = .0001) and a lower number of risk events (91 [9.2%] vs 93 [12.2%], P = .038). There was no significant difference in 30-day readmissions, avoidable day events, or code blue team activations. GAGL provides a framework for hospital organizations to improve provider communication, hospital efficiency, and patient safety.

Impact of orthogeriatric management on the average length of stay of patients aged over seventy five years admitted to hospital after hip fractures

2021 ◽  
Author(s):  
Pierre-Sylvain Marcheix ◽  
Camille Collin ◽  
Jérémy Hardy ◽  
Christian Mabit ◽  
Achille Tchalla ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Average Length ◽  
Discharge Rate ◽  
Length Of Hospital Stay ◽  
Median Length ◽  
Average Length Of Stay ◽  
Significant Difference

Abstract Introduction Hip fracture is a frequent and serious condition in the elderly. We conducted a retrospective cohort study to answer the following questions: (1) Could treatment in an orthogeriatric unit help to reduce the average length of stay for patients aged over 75 years admitted to hospital for the treatment of a hip fracture?; and (2) Could such treatment influence the post-operative outcomes of patients with hip fracture? Methods and materials Our study included 534 patients admitted to hospital between January 2017 and December 2018 for surgical treatment of a hip fracture. We compared 246 patients who received traditional orthopaedic care with 288 patients treated in an orthogeriatric unit. Results Our cohort included 410 women (77%). The average age was 87.5 ± six years, and 366 patients (68%) were living at home prior to the fracture. A statistically significant difference in median length of stay (from 10 to 9 days) was observed between patients who did and did not receive orthogeriatric unit treatment (groups 1 and 2; 95% CI: 0.64; 2.59; p = 0.001). There was no difference in pre-operative delay, intra-hospital mortality rate, place of recovery, rate of institutionalisation after six months, or the number of new fractures at 6 months between the groups. The mortality rate after six months was 23.6% and 21.3% in groups 1 and 2, respectively; the difference was not significant. Discussion Orthogeriatric unit treatment reduced the median length of stay by one day, in line with most previous studies. According to Pablos-Hernandez et al., multifaceted orthogeriatric treatment is most effective. In our study, only 38% of the patients received surgical treatment within 48 hours, where early surgery is key for reducing the length of hospital stay. The intrahospital mortality rate was 2.6%, which is comparable to literature data. The discharge rate did not differ by orthogeriatric treatment status, which is also consistent with previous findings (e.g. Gregersen et al.). Lastly, the mortality rate after six months was slightly reduced by orthogeriatric care. In line with this, Boddaert et al. reported a difference in mortality rate after six months between groups who did and did not receive orthogeriatric treatment (15% vs. 24%).

scholarly journals A Better Wound Care Assessment on Burn Patients

1970 ◽  
Vol 1 (5) ◽  
Author(s):  
Hendra Sanjaya ◽  
Aditya Wardhana
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Tissue Loss ◽  
High Morbidity ◽  
Burn Patients ◽  
Reduce Mortality Rate ◽  
Average Length Of Stay ◽  
Degree Burn ◽  
Care Assessment ◽  
Significant Difference

Backgrounds: Burn, a damage and tissue loss caused by heat with a high morbidity and mortality, have a many variation and complex problem that require special management. After a period of shock, there were infections that threaten the burn patients. These hazards aggravate the wound to become wider, and it affects the mortality and the length of stay. That is why to reduce mortality rate and length of stay, we need a proper wound care.Methods:A retrospective descriptive studies was perform on 2b degree burn patients (20-25%) that treated with tangential excision and mebo or tangential excision and stsg. Data was taken from burns unit Cipto Mangunkusumo hospital in period of January to December 2011.Results: There were 30 patients (73.2%) that have been treat with tangential excision and mebo, and 11 patients (26.8%) that have been treat with tangential excision and stsg. The average length of stay for the tangential excision and mebo is 22.47 ≈ 23 days(SD 4.361), whereas patients with tangential excision and stsg is 15.82 ≈16 days (SD 2.089). There were 8 patients (26.7%) with tangential excision and mebo that die, whereas patients with tangential excision and stsg were 2 patients (18.2%) that die. There were significant difference in the average length of stay (p = 0.018), but there was no difference in the proportion of patients dying status (P = 0.611).Conclusion:Wound care by tangential excision and stsg on 2b degree burn patient (20-25%), have a better outcome than patients treated by tangential excision and mebo.

scholarly journals Length of stay comparisons for private and public hospitals

2000 ◽  
Vol 23 (3) ◽  
pp. 162 ◽  
Author(s):  
Jennifer Badham ◽  
Jason Brandrup
Keyword(s):  
Length Of Stay ◽  
Public Hospital ◽  
Average Length ◽  
Public Hospitals ◽  
Private Hospitals ◽  
The Public ◽  
Average Length Of Stay ◽  
Private And Public

This analysis uses average length of stay as a proxy for efficiency, to compare the Australian private and public hospitalsectors. We conclude that private hospitals are more efficient than public hospitals in providing the range of care providedby private hospitals. However, public hospitals are more efficient in handling the casemix of the public hospital sector.The picture is more complicated when particular types of care (such as obstetric and psychiatric) are excluded.

Private psychiatric hospital care in Australia: a descriptive analysis of casemix and outcomes

2021 ◽  
pp. 103985622110512
Author(s):  
Jeffrey CL Looi ◽  
Tarun Bastiampillai ◽  
William Pring ◽  
Stephen R Kisely ◽  
Stephen Allison
Keyword(s):  
Length Of Stay ◽  
Effect Size ◽  
Average Length ◽  
Descriptive Analysis ◽  
Psychiatric Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
Average Length Of Stay ◽  
Improvement Effect ◽  
Substance Abuse Disorders

Objective: To provide a rapid clinical update on casemix, average length of stay, and the effectiveness of Australian private psychiatric hospitals. Methods: We conducted a descriptive analysis of the publicly available patient data from the Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service website, from 2015–2016 to 2019–2020. This was compared with corresponding reporting on public and private hospitals from the Australian Institute of Health and Welfare, and Australian Mental Health Outcomes and Classification Network. Results: In 2019–2020, there were 72 private psychiatric hospitals in Australia with 3582 acute beds. There were 42,942 inpatients with 1,286,470 days of care, and a mean length of stay 19.6 days (SD 13.9) for the financial year 2019–2020. The main diagnoses were major affective and other mood disorders (49%), and alcohol and other substance abuse disorders (21%). Clinician-rated outcome measures, that is, the HoNOS, showed an improvement effect size of 1.64, while the patient-rated MHQ-14 showed an improvement effect size of 1.18. Results are similar for previous years. Conclusions: Private psychiatric hospitals provide substantial, effective psychiatric care.

scholarly journals Effect of a provincial feline onychectomy ban on cat intake and euthanasia in a British Columbia animal shelter system

2021 ◽  
pp. 1098612X2110438
Author(s):  
Alexandre Ellis ◽  
Karen van Haaften ◽  
Alexandra Protopopova ◽  
Emilia Gordon
Keyword(s):  
British Columbia ◽  
Length Of Stay ◽  
Release Rate ◽  
Average Length ◽  
Animal Shelter ◽  
Destructive Behavior ◽  
Total Intake ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Cruelty To Animals

Objectives The aim of this study was to determine whether there was an increase in cat relinquishment for destructive scratching behavior, a change in overall feline surrender intake and euthanasia, or a change in average length of stay in a British Columbia shelter system after provincial legislation banning elective onychectomy. Methods Records of cats admitted to the British Columbia Society for the Prevention of Cruelty to Animals in the 36 months prior to (1 May 2015–30 April 2018, n = 41,157) and after (1 May 2018–30 April 2021, n = 33,430) the provincial ban on elective onychectomy were reviewed. Total intake numbers, euthanasia and length of stay were descriptively compared between periods. Proportions of cats and kittens surrendered for destructive scratching, as well as the proportion of cats and kittens surrendered with an owner request for euthanasia, were compared using two-sample z-tests of proportions. Results Destructive behavior was found to be an uncommon reason for surrender (0.18% of surrendered cats) during the study period. There was no statistically significant difference in the number of cats surrendered for destructive scratching behavior ( z = −1.89, P >0.05) after the provincial ban on elective onychectomy. On the contrary, the proportion of owner-requested euthanasias decreased after the ban ( z = 3.90, P <0.001). The total number of cats surrendered, the shelter live release rate and average length of stay all remained stable or improved following the ban, though causation could not be determined. Conclusions and relevance The findings in this study suggest that legislation banning elective onychectomy does not increase the risk of feline shelter relinquishment – for destructive behavior or overall – and is unlikely to have a significant effect on shelter euthanasia or length of stay.

Extrakorporális és intrakorporális anasztomózis rövid távú eredményeinek összehasonlítása malignus daganat miatt végzett laparoszkópos jobb oldali hemikolektómia esetén

2020 ◽  
Vol 73 (4) ◽  
pp. 148-152
Author(s):  
Kornél Vajda ◽  
László Sikorszki
Keyword(s):  
Length Of Stay ◽  
Gold Standard ◽  
Average Length ◽  
Colon Surgery ◽  
Right Hemicolectomy ◽  
Malignant Tumours ◽  
Short Term ◽  
Significant Difference ◽  
Laparoscopic Assisted ◽  
Laparoscopic Hemicolectomy

Összefoglaló. Bevezetés: A laparoszkópia térhódítása a jobb oldali colon műtéteknél is nyilvánvaló. Ma legtöbb helyen a laparoszkóposan asszisztált jobb oldali hemikolektómia extrakorporális anasztomózissal a gold standard. A morbiditás randomizált vizsgálatok alapján még 30% körüli. A technikai fejlődés lehetővé tette az intrakorporális anasztomózist. Célkitűzés: Retrospektív módon elemezni rosszindulatú jobb oldali vastagbéldaganat miatt végzett laparoszkópos hemikolektómiák rövid távú eredményeit a két módszer összehasonlításával. Eredmények: 2018. 01. 01. – 2019. 12. 31. között 184 jobb oldali hemikolektómiát végeztünk, ezek közül 122 történt malignus betegség miatt. 51 esetben nyitott és 71 esetben laparoszkópos műtét történt. 37 férfi (átlagéletkor: 70,59 év) és 34 nő (átlagéletkor: 72,14 év) volt. 50 esetben extrakorporális (EA) és 21 esetben pedig intrakorporális anasztomózist (IA) végeztünk. Az EA csoportban 18, míg az IA csoportban 3 szövődmény alakult ki 30 napon belül (p = 0,067). Az EA csoportból 3, az IA csoportból 1 beteget veszítettünk el 30 napon belül (p = 0,66). Az átlagos ápolási idő az EA csoportban 9,48 (5–32) nap, míg az IA csoportban 6,52 (4–19) nap volt (p = 0,001) a szövődményes esetekkel együtt. A szövődményes esetek nélkül az EA csoportban 6,35 (5–10) nap, az IA csoportban pedig 5,55 (4–8) napnak bizonyult (p = 0,09). A műtéti idő pedig az EA csoportban 147 (90–240) perc, az IA csoportban pedig 146,47 (90–265) perc volt (p = 0,11). Konklúzió: Az irodalommal összhangban azt találtuk, hogy IA esetén kevesebb a szövődmény, ezzel is összefüggésben rövidebb az átlagos ápolási idő, és a műtéti időt tekintve nincs szignifikáns különbség. Ezeket figyelembe véve az intrakorporális anasztomózis javasolható jobb oldali laparoszkópos hemikolektómia esetén. Summary. Introduction: Laparoscopy became evident for right-sided colon surgery too. Today the laparoscopic-assisted right-hemicolectomy is the gold standard with extracorporeal anastomosis. Morbidity according to randomized trials is still approximately 30%. The development of the surgical technique resulted in the creation of intracorporeal anastomosis. Our aim was to compare the short-term results of the two methods. Aim: To analyse the short-term results of right-sided hemicolectomy that were performed due to malignant tumours with the comparison of the two methods. Results: A cohort of 184 right-sided hemicolectomy were performed from 01.01.2018 to 31.12.2019 from which 122 were operated on because of a malignant disease. 51 open and 71 laparoscopic operations were performed. The average age of 37 men and 34 women were 70.59 and 72.14 years, respectively. 50 patients underwent extracorporeal (EA) anastomosis and 21 intracorporeal (IA) anastomosis. Within 30 days the number of complications were 18 in the EA group and 3 in the IA group (p = 0.067). 3 from the EA group and 1 from IA group died within 30 days (p = 0.66). The average length of stay were 9.48 days in the EA group and 6.52 days in the IA group together with the complicated cases (p = 0.001) while 6.35 days and 5.55 days without the complicated cases (p = 0.09). The average duration of operation was 147 minutes in the EA and 146.47 minutes in the IA group (p = 0.11). Conclusion: We found concordance with the literature that there are fewer complications in case of IA which might be related to shorter length of stay. There is no significant difference between the surgical times. Bearing these facts in mind, IA might be suggested for right- sided laparoscopic hemicolectomy.

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