The Effect of Length of Hospital Stay and Patient Factors on Patient Satisfaction in an Academic Hospital

Orthopedics ◽  
2020 ◽  
Vol 43 (6) ◽  
pp. 373-379
Author(s):  
Waqaar Diwan ◽  
Paul A. Nakonezny ◽  
Joel Wells
Keyword(s):  
Patient Satisfaction ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Academic Hospital ◽  
Patient Factors

scholarly journals The independent patient factors that affect length of stay following hip fractures

2018 ◽  
Vol 100 (7) ◽  
pp. 556-562 ◽  
Author(s):  
T Richards ◽  
A Glendenning ◽  
D Benson ◽  
S Alexander ◽  
S Thati
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Patient Factors ◽  
Mobility Status

Introduction Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. Methods A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. Results American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. Conclusions Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.

scholarly journals Risk Factors for Impaired Patient-Reported Satisfaction and Increased Length of Hospital Stay Following Hysterectomy on Benign Indications in Premenopausal Women: a Study From the Swedish National Register for Gynecological Surgery

2019 ◽  
Vol 80 (03) ◽  
pp. 288-299
Author(s):  
Ninnie Borendal Wodlin
Keyword(s):  
Risk Factors ◽  
Patient Satisfaction ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Premenopausal Women ◽  
Gynecological Surgery ◽  
National Register ◽  
Logistic Regression Models ◽  
Patient Reported ◽  
The Impact

Abstract Introduction The aims of the study were to evaluate the impact of intra- and postoperative complications on satisfaction one year after hysterectomy for benign conditions, to determine risk factors for low patient satisfaction and to analyze whether complications were associated with the length of hospital stay. Material and Methods A retrospective study of 27 938 women from the Swedish National Register for Gynecological Surgery undergoing hysterectomy for benign conditions between January 2004 and June 2016. Data were obtained from prospectively collected pre-, peri- and postoperative forms. Statistical analyses were performed using multivariable logistic regression models. Crude and adjusted odds ratios and 95% confidence intervals are presented. Results More than 90% were satisfied with the hysterectomy. Dissatisfaction was associated with complications. Pelvic pain as indication, preoperatively having less expectations to get rid of symptoms or being alleviated from surgery, and current smoking were also risk factors for low patient satisfaction. Vaginal and abdominal subtotal hysterectomies were associated with high satisfaction. Occurrence of complications intra- and postoperatively before discharge was associated with increased length of hospital stay, as well as occurrence and severity of complications reported after discharge from hospital. Conclusions Complications were strongly associated with lower patient satisfaction. Preoperative expectations of surgery, indication, mode of surgery and life-style factors had impact on the satisfaction. Patient-centered information to ensure realistic expectations and prevention of complications seem to be essential to gain optimal patient satisfaction with surgery.

scholarly journals STAPLED HEMORRHOIDECTOMY

2016 ◽  
Vol 23 (12) ◽  
pp. 1505-1512
Author(s):  
Saleem Arif ◽  
Talat Waseem ◽  
Javaid-ur-Rehman Ashraf ◽  
Farooq Ahmad
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Stapled Hemorrhoidectomy ◽  
Recurrence Rates ◽  
Patient Satisfaction Score ◽  
Grade Ii

Stapled hemorrhoidectomy has been recently advocated as a procedure of choicefor prolapsed hemorrhoids. Studies consistently show that this newer technique is associatedwith less postoperative pain and may be cost effective; however others have questioned its moregeneralized application. Study Design: Randomized controlled trial. Setting: Tertiary hospitalsettings at Services Institute of Medical Sciences, and Ittefaq Hopsital Trust, Lahore. Period:2002 to 2007. Patients & Methods: Short and long-term outcomes of stapled and conventionalhemorrhoidectomy were compared. 538 patients with Grade II, III & IV hemorrhoids wererandomized to undergo either stapled (n=251) or conventional hemorrhoidectomy (n=287).Perioperative and postoperative complications, length of hospital stay, patient satisfactionand long-term recurrence rates for at least 5 postoperative years were analyzed. Results:In the short term, patients undergoing stapled hemorrhoidectomy (n=251) were associatedwith less operative time, less postoperative pain, shorter hospital stay and acceptable overallfirst post-op year patient satisfaction score as compared to patients undergoing conventionalhemorrhoidectomy (n=287). In the long-term however; there were significantly higher ratesof recurrence and tenesmus in stapled group. Over the postoperative years, these rates ofcomplications increased significantly among patients undergoing stapled hemorrhoidectomy.The subgroup analysis showed that Grade IV patients undergoing stapled hemorrhoidectomyhad higher long term postoperative complication rate and poor patient satisfaction scores asopposed to Grade III hemorrhoid patients and had to undergo secondary surgical interventions.Conclusions: The stapled hemorrhoidectomy is an acceptable treatment for selected patientswith Grade II & III hemorrhoids in terms of less postoperative pain and shorter hospital stayat expense of mildly higher long- term recurrence rate; however for grade IV hemorrhoidsstapled hemorrhoidectomy is clearly is an ‘under treatment’ in the long-term as opposed toconventional hemorrhoidectomy.

scholarly journals A comparative study between total laparoscopic hysterectomy and total abdominal hysterectomy for benign uterine pathologies at tertiary care institute, Udaipur

2021 ◽  
Vol 10 (10) ◽  
pp. 3806
Author(s):  
Shatendra Kumar Goyal ◽  
Madhubala Chauhan ◽  
Babita Kanwat ◽  
Dinesh Mehra
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Study Patient ◽  
Early Ambulation

Background: Hysterectomy is one of the most commonly performed procedures in gynaecological surgery. The most common indication is benign uterine disease. As the time is passing trend is towards those approaches which are minimally invasive, less painful, have less complications, less blood loss and are more cosmetic. Thus, total laparoscopic hysterectomy has gained popularity. The purpose of this study was to compare the 2 different routes of hysterectomy.Methods: In this prospective randomized observational study patients undergoing both the types of hysterectomy, that is, TAH (total abdominal hysterectomy) and TLH (total laparoscopic hysterectomy) during 2 year period at Rajkiya Pannadhay Mahila Chikitsalaya RNT medical college Udaipur were included in the study. 50 women (25 in each group) aged between 31-72 years were included into the study.Results: We observed that duration of surgery was found to be longer in TLH than TAH (112.56±19.45 min versus 57.9±19.26 min, P<0.001 (HS)). The length of hospital stay was less in TLH than TLH (p=0.0001) and the amount of intra-operative blood loss were also less in TLH than TAH (163.60±44.15 versus 313.20±123.48 ml, p<0.001). TLH group had early ambulation compared to TAH group (2.24±0.44 day versus 3.12 ±0.33 day, p<0.001), difference on the basis of length of hospital stay was highly significant which was shorter in TLH than TAH (4.40±1.15 versus 10.32±8.19 days, respectively; p<0.001). In current study patient satisfaction level was found highly significant between TLH and TAH (100% versus 56%, p<0.001).Conclusions: TLH is a safe and effective method of doing hysterectomy. The present study concluded that TLH is associated with less hospital stay, less blood loss, less use of analgesics, early ambulation, early start of oral feed, and better patient satisfaction. 

scholarly journals LAPAROSCOPIC STAPLER APPENDECTOMY IN PEDIATRIC PATIENTS

2021 ◽  
Vol 70 (2) ◽  
pp. 122-128
Author(s):  
Daniela Dobrițoiu ◽  
◽  
Alin Stoica ◽  
Simona-Gabriela Tudorache ◽  
Laura-Mihaela Ion ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Pediatric Patients ◽  
Length Of Hospital Stay ◽  
Treatment Method ◽  
Complicated Appendicitis ◽  
Academic Hospital ◽  
Time Of Surgery ◽  
Number Of Patients ◽  
Multiple Variants

Introduction. Acute appendicitis is the most frequent cause of surgical abdominal pain in children. There are multiple variants of surgical treatment of acute appendicitis, including laparoscopic stapler appendectomy. Aim. We proposed to present our experience regarding laparoscopic stapler appendectomy as an alternative treatment method in children diagnosed with appendicitis. Material and method. In this retrospective descriptive, observational study we analyzed the data of children admitted with appendicitis to Ponderas Academic Hospital between January 2018 and October 2020. Results. 78 laparoscopic appendectomies were performed in children with ages of 3 to 16 years old. Of these, 70 were performed using mechanical suturing devices. Time of surgery was 77 minutes in 2018, 76 minutes in 2019 and 91 minutes in 2020. In 2020 the number of complicated appendicitis was double than in 2019 and six times higher than in 2018 but time of surgery was smaller in these cases in 2020 with longer hospital stay. Conclusions. In 2020 we observed that was a smaller number of patients operated, with higher time of surgery, length of hospital stay, more complicated appendicitis (regarding drainage usage) but with smaller time of surgery in these complicated cases which indicates the effectiveness of using the stapler.

scholarly journals Defining treatment strategy for uncomplicated appendicitis based on patient satisfaction feedback: A cross-sectional study

2020 ◽  
Author(s):  
Kyota Tatsuta ◽  
Shinichiro Miyazaki ◽  
Masahito Ogiku ◽  
Takashi Harada ◽  
Nishiwaki Yoshiro
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Surgical Intervention ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Uncomplicated Appendicitis ◽  
Significant Difference ◽  
Degree Of Satisfaction

Abstract Background Two surgical strategies are available for appendicitis: emergency laparoscopic appendectomy and interval laparoscopic appendectomy. However, timing of surgical intervention remains debatable. This study aimed to compare the surgical outcomes of emergency laparoscopic appendectomy (ELA) and interval laparoscopic appendectomy (ILA) and conduct a questionnaire survey to investigate the use of ELA and patient satisfaction with regard to treatment. Methods We included 162 patients who underwent laparoscopic appendectomy at our hospital. Outcomes were assessed by operation time, blood loss, postoperative fasting time, length of hospital stay, and complication rate. Patient satisfaction was measured by questionnaire addressing degree of satisfaction, pre-surgery anxiety, and length of hospital stay. Continuous variables were compared by Student’s t-test, and discrete variables, expressed as percentages, were analyzed via chi-squared test. Results Of 162 patients, 74 (46%) and 88 (54%) received emergency and ILA, respectively. No significant difference was observed in the operation time, blood loss, length of hospital stay, or complication rate. Among 66 patients who responded to the questionnaire (28 emergency, 38 interval), a significant difference was observed only in the degree of satisfaction regarding the timing of the surgical intervention (p = 0.04). Conclusions Surgical outcomes of emergency and interval appendectomy were equivalent; however, patient satisfaction favored emergency appendectomy, suggesting it is a preferable approach for the treatment of uncomplicated appendicitis. Trial registration: NA

scholarly journals Management of minor burns during the COVID-19 pandemic: A patient-centred approach

2021 ◽  
Vol 7 ◽  
pp. 205951312110205 ◽  
Author(s):  
Mohammed Farid ◽  
Yasser Al Omran ◽  
Darren Lewis ◽  
Alan Kay
Keyword(s):  
Patient Satisfaction ◽  
Hospital Stay ◽  
Telephone Survey ◽  
Self Care ◽  
Length Of Hospital Stay ◽  
Effective Model ◽  
Queen Elizabeth Hospital ◽  
The Uk ◽  
High Degree

Introduction: The UK government introduced lockdown measures on 23 March 2020 due to the first wave of the COVID-19 pandemic. A restructuring of clinical services was necessary to accommodate mandatory changes while also maintaining the best possible standards for patient care. The present study explored the initial management, follow-up and patient-reported outcomes of burn injuries <15% total body surface area (TBSA) during the height of the COVID-19 lockdown at a tertiary burns centre. Methods: A retrospective review of all adult patients with burns <15% TBSA during the national lockdown (23 March 2020 to 10 May 2020) was undertaken at The Queen Elizabeth Hospital Birmingham (QEHB), UK. All referrals from non-QEHB telemedicine (external) or QEHB emergency (internal) departments were reviewed for management, length of hospital stay and pattern of follow-up (ward attender, self-care, community or outreach nurses). A telephone survey based on a structured questionnaire was conducted to establish patients’ satisfaction. Results: A total of 84 burn patients were included in the study. The mean age was 39 years (age range = 19–91 years) and the male:female ratio was 4:1. Patients were managed non-operatively (n = 69, 82%) or operatively (n = 15, 18%). Patients attended the ward attender acute burns clinic only once (n = 36, 61%). The telephone survey captured 70% (n = 59) of the study population and 57 patients (97% of respondents) were pleased with the ongoing care and burn healing. Conclusion: The integration of patient led self-care, reduction in admissions, minimal clinics attendance and a telemedicine follow-up is an effective model for small burns management during the COVID-19 pandemic. A high degree of patient satisfaction was achieved with continuous and approachable communication channels with the burn multidisciplinary team. We continue to implement this effective model of burns management throughout the COVID-19 pandemic and the subsequent period. Lay Summary The lockdown measures due to the first wave of COVID-19 pandemic affected the way we manage all medical emergencies including burns. The initial management, follow-up and patient satisfaction for small burn injuries during lockdown has not been reported previously. The aim of this study is to examine the outcome in terms of small burn management, hospital stay, number of clinic reviews, healing and patient satisfaction during the lockdown period in a burn centre in the UK. This would look at the need for operations and whether patients stayed longer if they required an intervention. We reviewed adult patients with small burns during the national lockdown (23 March 2020 to 10 May 2020) at The Queen Elizabeth Hospital Birmingham (QEHB). All referrals from telemedicine, referral system (external) or QEHB (internal) were reviewed for management, length of hospital stay and pattern of follow-up. Patients were reviewed in the acute burns clinic and given advice for burn management and dressing for self-care. Follow-up was mostly via email (telemedicine) A telephone survey based on a structured questionnaire was conducted to find out patients’ satisfaction. Four times more men than women had small burns during the lockdown period. The average age was 39 years. The majority were managed conservatively with dressings (82%) and a small proportion required an operation (18%). Most patients attended the acute burns clinic only once (61%) for initial assessment and management. The telephone survey captured 70% of patient and 97% of respondents were pleased with the care and burn healing. The integration of patient-led self-care, reduction in admissions, minimal clinics attendance and a telemedicine follow-up is an effective model for burns management during the COVID-19 pandemic. A high degree of patient satisfaction was achieved with continuous and approachable communication channels with burn multidisciplinary team. We continue to implement this effective model of burns management throughout the COVID-19 pandemic and the subsequent period.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

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