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

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 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

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.

Impact of Length of Stay on Functional Outcomes of TBI Patients

2005 ◽  
Vol 71 (11) ◽  
pp. 920-930 ◽  
Author(s):  
M.L. Hawkins ◽  
F.D. Lewis ◽  
R.S. Medeiros
Keyword(s):  
Length Of Stay ◽  
Functional Outcomes ◽  
Inpatient Care ◽  
Average Length ◽  
Functional Independence ◽  
Average Length Of Stay ◽  
Group 2 ◽  
The Impact ◽  
Group 1

The purpose of this study was to compare the functional outcomes of two groups of patients with traumatic brain injury (TBI) with attention to the impact of reduced length of stay (LOS) in the trauma center (TC) and rehabilitation hospital (RH). From 1991 to 1994, 55 patients, Group 1, with serious TBI (Abbreviated Injury Scale score ≥3) were admitted to a level 1 TC and subsequently transferred to a comprehensive inpatient RH. These results have been previously published. From 1996 to 2002, 64 similarly injured patients, Group 2, received inpatient care at the same TC and RH. These patients had a marked decrease in length of stay. Functional Independence Measures (FIM) were obtained at admission (Adm), discharge (D/C), and at 1 year follow-up for both groups. The average length of stay at the TC dropped from 36 days in Group 1 to 26 days in Group 2. In addition, the average length of stay at the RH dropped from 46 days (Group 1) to 25 days (Group 2); overall, an average reduction of 31 days of inpatient care. Group 2 had significantly lower FIM scores at the time of RH discharge for self-care, locomotion, and mobility compared to Group 1. At the 1 year follow-up, however, there were no significant differences between Groups 1 and 2 in these FIM scores. FIM scores at 1 year were higher in Group 2 for communication (90% vs 71%) and social cognition (77% vs 49%) compared to Group 1. Over one-fourth of each group returned to work by the 1 year follow-up. Socially disruptive behavior occurred at least weekly in 28 per cent (Group 1) and 23 per cent (Group 2) of patients. The outcome for serious TBI is better than generally perceived. Reduction of inpatient LOS did not adversely affect the ultimate functional outcome. The decreased LOS placed a greater demand on outpatient rehabilitative services as well as a greater burden on the family of the brain-injured patient

A long wait: barriers to discharge for long length of stay patients

2018 ◽  
Vol 94 (1116) ◽  
pp. 546-550 ◽  
Author(s):  
Emma Jane Zhao ◽  
Apurva Yeluru ◽  
Lakshman Manjunath ◽  
Lei Ray Zhong ◽  
Hsiao-Tieh Hsu ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Chart Review ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Care Hospital ◽  
Healthcare Staff ◽  
Care Capacity ◽  
Improve Cost

IntroductionReducing long length of stay (LLOS, or inpatient stays lasting over 30 days) is an important way for hospitals to improve cost efficiency, bed availability and health outcomes. Discharge delays can cost hundreds to thousands of dollars per patient, and LLOS represents a burden on bed availability for other potential patients. However, most research studies investigating discharge barriers are not LLOS-specific. Of those that do, nearly all are limited by further patient subpopulation focus or small sample size. To our knowledge, our study is the first to describe LLOS discharge barriers in an entire Department of Medicine.MethodsWe conducted a chart review of 172 LLOS patients in the Department of Medicine at an academic tertiary care hospital and quantified the most frequent causes of delay as well as factors causing the greatest amount of delay time. We also interviewed healthcare staff for their perceptions on barriers to discharge.ResultsDischarge site coordination was the most frequent cause of delay, affecting 56% of patients and accounting for 80% of total non-medical postponement days. Goals of care issues and establishment of follow-up care were the next most frequent contributors to delay.ConclusionTogether with perspectives from interviewed staff, these results highlight multiple different areas of opportunity for reducing LLOS and maximising the care capacity of inpatient hospitals.

scholarly journals Length of Stay of Psychiatric Admissions in a Tertiary Care Hospital

2018 ◽  
Vol 56 (210) ◽  
pp. 593-597
Author(s):  
Madhur Basnet ◽  
Nidesh Sapkota ◽  
Suren Limbu ◽  
Dharanidhar Baral
Keyword(s):  
Logistic Regression ◽  
Length Of Stay ◽  
Average Length ◽  
Tertiary Care ◽  
Psychiatric Ward ◽  
Care Hospital ◽  
Factors Affecting ◽  
Factors Associated ◽  
Psychiatric Admissions ◽  
Co Morbidity

Introduction: The length of stay among psychiatric in-patients is usually longer than that of others. In-patient management is costly and longer length of stay can lead to catastrophic costs. We conducted this study to explore about the length of stay of psychiatric admissions and factors affecting it.Methods: We collected the data of all the patients admitted to the psychiatric ward of B. P. Koirala Institute of Health Sciences from 1st January 2007 to 31st December 2016 from the database of the medical records section after ethical approval. The sociodemographic and clinical variables were analyzed using SPSS 20.0 version. Length of stay more than 3 weeks was considered as long stay. Bivariate and multivariable logistic regression analyses were conducted to identify factors associated with length of stay.Results: There were 3687 admissions during the study period. The average length of stay was 19.36 (±13.14) days. On logistic regression, the factors associated with shorter length of stay were: male gender (aOR= 0.79, 95%CI: 0.68-0.93), being self employed (aOR= 0.17, 95%CI: 0.12-0.22), homemakers (aOR= 0.18, 95%CI: 0.14-0.24), farmers (aOR= 0.20, 95%CI: 0.15-0.27) and students (aOR= 0.23, 95%CI:0.17-0.32). Similarly, factors associated with longer length of stay were: being from other Eastern Terai districts(aOR=1.37, 95%CI: 1.11-1.70), other Eastern Hill districts (aOR= 1.68; 95%CI: 1.29-2.20), diagnosis of schizophrenia and related disorders (aOR=4.01, 95%CI: 1.34-12.0), having medical co-morbidity (aOR= 3.47; 95%CI: 2.49-4.84) and being readmitted (aOR= 1.23, 95%CI: 1.03-1.47).Conclusions: There was significant association of length of stay with gender, age, address, occupation, diagnosis and readmission

scholarly journals Outcomes of Extravesical Versus Intravesical Ureteral Reimplantation

2004 ◽  
Vol 4 ◽  
pp. 195-197
Author(s):  
Leah P. McMann ◽  
Byron D. Joyner
Keyword(s):  
Length Of Stay ◽  
Vesicoureteral Reflux ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Renal Ultrasound ◽  
Voiding Cystourethrogram ◽  
Ureteral Reimplantation ◽  
Success Rates ◽  
Average Length Of Stay

Purpose: The purpose of our study was to examine outcomes and compare length of stay after extravesical and intravesical ureteral reimplantation at our institution. Materials and Methods: Retrospective review was performed of 30 patients (55 ureters) with vesicoureteral reflux who underwent either the Cohen (intravesical) cross-trigonal procedure or the extravesical (detrusorrhaphy) approach. Each patient had documented follow-up consisting of a postoperative renal ultrasound and/or a voiding cystourethrogram (VCUG). Inclusion criteria was the presence of primary vesicoureteral reflux. Exclusion criteria were patients who had undergone a previous repair and patients in whom results of neither the renal ultrasound nor the VCUG were available. Results: There were no significant cases of obstruction or wound infection with either approach. Two patients who underwent the extravesical approach had persistent reflux on VCUG three months postoperatively, but both resolved by fifteen months. Average length of stay was only 3.00 ± 1.33 days for the extravesical approach, compared to 5.36 ± 1.75 days for the intravesical approach ( P = .0003 ). Conclusions: Given that by fifteen months success rates were the same with either approach, the extravesical approach is comparable to the intravesical technique and is a viable option in terms of outcome and economics given the shorter length of hospital stay.

scholarly journals Distance from referral hospital as a risk factor for mortality and length of stay of neonates admitted in a tertiary care hospital

2019 ◽  
Vol 6 (11) ◽  
pp. 4912
Author(s):  
Kawal Krishen Pandita
Keyword(s):  
Risk Factor ◽  
Length Of Stay ◽  
Average Length ◽  
Tertiary Care ◽  
Newborn Care ◽  
Referral Hospital ◽  
Care Hospital ◽  
Prolonged Stay ◽  
Neonatal Deaths ◽  
District Hospitals

Background: Around 66% of infant and over 50% of under-five mortality occurs in newborn period. 99% of neonatal deaths occur in low and middle income countries. Most of these deaths can be prevented by suitable interventions at various levels. The premise of the study is that the neonates who require long transportation (>1 hour) have higher chances of mortality or prolonged stay in the hospital.Methods: A retrospective retrieval of data and prospective interview was conducted in G.B Pant children’s hospital Srinagar, an associated hospital of Govt. Medical College Srinagar in North India.Results: During the period of study 1431 neonates from twelve districts of the state were referred to the hospital for treatment, out of whom, 102 (7.13%) could not be saved. Neonatal death rate was found highest (11.11%) in neonates referred from districts of category-III (>100 kms from the referral hospital), followed by category-II (50-100 kms from the referral hospital) and category-I (>50 kms from the referral hospital). Average length of stay was observed longest for the neonates referred from districts of category-III followed by category-II and category-I.Conclusions: Several other studies found that transfer of sick neonates from another health facility were associated with relatively higher probability of morbidity and mortality after controlling for other predictors. Distance no doubt is a risk factor for neonatal outcome of referred neonates as we have observed in our study. To minimize neonatal deaths it is necessary to strengthen the perinatal services sick newborn care unit {(SNCUs) in district Hospitals)}.

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