scholarly journals Musculoskeletal malignant neoplasms hospitalisation in Victoria

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.

Comparison of Inpatient Standard-of-Care to Outpatient Oritavancin Therapy for Patients With Acute Uncomplicated Cellulitis

2021 ◽  
pp. 089719002110212
Author(s):  
Brandy Williams ◽  
Justin Muklewicz ◽  
Taylor D. Steuber ◽  
April Williams ◽  
Jonathan Edwards
Keyword(s):  
Hospital Readmission ◽  
Average Length ◽  
Hospital Readmissions ◽  
Standard Of Care ◽  
Economic Outcomes ◽  
Day Hospital ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Average Length Of Stay ◽  
Observational Cohort ◽  
The Difference

Background: Shifting inpatient antibiotic treatment to outpatient parenteral antimicrobial therapy may minimize treatment for acute bacterial skin and skin structure infections, including cellulitis. The purpose of this evaluation was to compare 30-day hospital readmission or admission due to cellulitis and economic outcomes of inpatient standard-of-care (SoC) management of acute uncomplicated cellulitis to outpatient oritavancin therapy. Methods: This retrospective, observational cohort study was conducted at a 941-bed community teaching hospital. Adult patients 18 years and older treated for acute uncomplicated cellulitis between February 2015 to December 2018 were eligible for inclusion. Information was obtained from hospital and billing department records. Patients were assigned to either inpatient SoC or outpatient oritavancin cohorts for comparison. Results: 1,549 patients were included in the study (1,348 in the inpatient SoC cohort and 201 in the outpatient oritavancin cohort). The average length of stay for patients admitted was 3.6 ± 1.5 days. The primary outcome of 30-day hospital readmission or admission due to cellulitis occurred in 49/1348 (3.6%) patients in the inpatient SoC cohort versus 1/201 (0.5%) in the outpatient oritavancin cohort (p = 0.02). The difference between costs and reimbursement was improved in the outpatient oritavancin group (p < 0.001). Conclusion: Outpatient oritavancin for acute uncomplicated cellulitis was associated with reduction in 30-day hospital readmissions or admissions compared to inpatient SoC. Beneficial economic outcomes for the outpatient oritavancin cohort were observed. Additional studies are required to confirm these findings.

scholarly journals LO046: Factors associated with hospital admission following asthma exacerbations: a systematic review

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S46-S46 ◽  
Author(s):  
B.H. Rowe ◽  
N. Arrotta ◽  
J. Hill ◽  
E. Dennett ◽  
M. Harries
Keyword(s):  
Hospital Admissions ◽  
Data Extraction ◽  
Statistical Significance ◽  
Grey Literature ◽  
Included Study ◽  
Significance Level ◽  
Factors Associated ◽  
Admission Rates ◽  
Literature Searches ◽  
Number Of Patients

Introduction: Patients with asthma frequently present to the emergency department (ED) with exacerbations; however, a select number of patients require admission to hospital. The objective of this study was to summarize the evidence regarding asthma-related hospital admissions and factors associated with these admissions following ED presentation. Methods: Comprehensive literature searches were conducted in seven electronic databases (database inception to 2015); manual and grey literature searches were also performed. Studies reporting disposition for adults after ED presentation were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS); standardized data-collection forms were used for data extraction. Admission proportions and factors associated with admission at a statistical significance level (p<0.05) were reported. Results: Out of an initial 5865 identified articles, 37 articles met full inclusion criteria. Admission proportions were reported in 25/37 studies, ranged from 1% to 37%, and collectively demonstrated a decline of ~9% in admissions between 1993 and 2012. Studies including a >50% Caucasian ethnicity were found to have a median admission proportion of 13% (interquartile range [IQR]= 7, 20) versus studies with >50% non-Caucasian ethnicity at 22% (IQR=20, 28). Age, female sex, and previous hospitalizations for asthma exacerbation were the most individually identifiable factors associated with admission. Presenting features and medication profile were the most frequent domains associated with admission. Conclusion: Admission rates have decreased approximately 9% in a nearly 20-year span and seem to be higher in studies involving mostly non-Caucasian ethnic groups. Demographic factors, markers of severity obtained by history or at ED presentation, and medication profile could be assessed by ED clinicians to effectively discern patients at high risk for admission.

Recent Critical Trends in Mental Hospital Admissions in the Oxford Region

1962 ◽  
Vol 108 (452) ◽  
pp. 59-67 ◽  
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.

scholarly journals Risk factors for acute psychiatric readmission

1997 ◽  
Vol 21 (10) ◽  
pp. 600-603 ◽  
Author(s):  
Mandy Dixon ◽  
Emma Robertson ◽  
Mohan George ◽  
Femi Oyebode
Keyword(s):  
Risk Factors ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
Service Planning ◽  
Living Alone ◽  
Retrospective Case ◽  
Psychiatric Readmission ◽  
Factors Associated ◽  
Hospital Readmission Rate ◽  
Discharge Against Medical Advice

A retrospective case note study explored readmissions to an acute psychiatric in-patient unit within six months of discharge. The study aimed to calculate a hospital readmission rate, to investigate the timing of readmissions, and to identify risk factors associated with readmission. The readmission rate was 27% with the majority of readmissions occurring within three months after discharge, suggesting the need for investigation of such early readmissions. The three factors found to predict readmission were: discharge against medical advice, number of previous admissions, and living alone or with family rather than in care. Implications for hospital service planning are considered.

scholarly journals Comparison of three antimicrobial strategies in diabetic foot infections post-amputation

2019 ◽  
Vol 6 ◽  
pp. 204993611986454
Author(s):  
Samarth P. Shah ◽  
Ana Negrete ◽  
Timothy Self ◽  
Jaclyn Bergeron ◽  
Jennifer D. Twilla
Keyword(s):  
Patient Outcomes ◽  
Diabetic Foot ◽  
Hospital Admissions ◽  
Average Length ◽  
Primary Diagnosis ◽  
Antimicrobial Treatment ◽  
Optimal Route ◽  
Average Length Of Stay ◽  
Diabetic Foot Infections ◽  
Selection Of

Background: The 2012 Infectious Disease Society of America (IDSA) guidelines recommend antimicrobial treatment of diabetic foot infections (DFIs) post-amputation, but the optimal route and duration are poorly defined. Objective: The objective of this study was to determine whether the selection of a specific antimicrobial treatment modality affected hospital and patient outcomes. Methods: This was a retrospective review of hospital admissions of adults admitted to ourhealthcare system with a primary diagnosis of DFIs post-amputation. The groups were separated into patients who received intravenous antimicrobials (IV), oral antimicrobials (PO), or no antimicrobials (NA). Outcomes included average length of stay among others. Results: Of the 200 patients screened, 120 patients were included (IV n = 72; PO n = 20; NA n = 28). No statistically significant differences were identified in average LOS (IV = 9.97 ± 5.85, PO = 8.83 ± 7.37, NA = 9.33 ± 5.91 days; p = 0.73). However, post-operative (post-op) LOS was significantly shorter in the PO group (PO = 3.43 ± 2.56, IV = 7.34 ± 5.95, NA = 5.81 ± 4.18 days; p = 0.0001). Conclusion: The results of our study indicate that a PO antimicrobial treatment strategy post amputation for DFIs has the potential to decrease post-op LOS without increasing the risk of readmission. Based on the results of our study, we feel consideration should be given to transition to oral antimicrobials soon after amputation to facilitate discharge and decrease the utilization of intravenous antimicrobials.

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

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.

Hospital readmission rate for febrile neutropenia (FN) following high dose cytarabine (HiDAC) consolidation chemotherapy for acute myeloid leukemia (AML).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18513-e18513
Author(s):  
Caitlin Siebenaller ◽  
Tomas Radivoyevitch ◽  
Connie Cheng ◽  
Hetty Carraway ◽  
Sudipto Mukherjee ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Myeloid Leukemia ◽  
Readmission Rate ◽  
Treatment Cycle ◽  
High Dose ◽  
Consolidation Chemotherapy ◽  
Readmission Rates ◽  
Factors Associated ◽  
Hospital Readmission Rate ◽  
High Dose Cytarabine

e18513 Background: FN is an anticipated complication of consolidation with HiDAC for AML, though precise descriptions of incidence, type, and severity of infection leading to FN are lacking. Since AML patients (pts) with FN after HiDAC are routinely readmitted to the hospital, there is a likely impact on measures of quality and value in this population. Methods: Our primary aim was to define the rate of FN inpatient readmissions among all HiDAC cycles. Secondary aims included: estimating rates of all-cause readmissions, clinical (e.g., probable pneumonia per imaging) and microbiologically-documented infections, and identify pts-specific risk factors associated with readmission. Readmission per patient were modeled using Poisson regression, with means proportional to total cycles exposed, and logistic regression for the probability of FN per treatment cycle. Results: We identified 150 AML pts ≥ 18 years of age, who received at least one cycle of HiDAC consolidation (1000-3000 mg/m2 for six doses) in 2009-2016. The median age was 50 (range 19-69); 55% were female and 45% were male. For 417 HiDAC cycles analyzed (87% at 3000 mg/m2), all pts received flouroquinalone prophylaxis and the overall readmission rate was 49% (203/417), of which 86% (174/203) were for FN. Median time to FN hospital admission was 18 days (range 10-22) from the start of HiDAC. Of the 174 FN readmissions, 60% had documented infections. Of these infections, 35% were bacteremia, 29% other bacterial, 24% fungal, 6% sepsis, and 6% viral. Females had higher FN readmission rates (RR 1.7 (1.3, 2.4) p = 0.007), as did pts with higher BMI (RR 1.06 (1.01, 1.09) p = 0.005), while age and HiDAC dose were not associated with readmission. Only 34% of all readmissions were in the absence of a documented infection. Conclusions: The majority of FN readmissions were associated with clinical or microbiologically documented infections and are not avoidable. Females and pts with higher BMI were more likely to be readmitted. Readmission of AML pts following HiDAC is expected, and therefore, should be excluded from measures of value and quality.

Reduction of Length of Stay in an Acute Care Psychiatric Unit

1996 ◽  
Vol 41 (1) ◽  
pp. 49-51 ◽  
Author(s):  
Therese Edward-Chandran ◽  
De Malcolm ◽  
RC Bowen
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Readmission Rate ◽  
Average Length ◽  
National Level ◽  
Care Facility ◽  
Initial Increase ◽  
Psychiatric Unit ◽  
Readmission Rates ◽  
Average Length Of Stay

Objective: To study the association between reduced length of stay in an acute care psychiatric unit and readmission rates. Method: Data on average length of stay, total discharges and readmission rates from April 1988 to March 1994 for 2 hospitals with high average lengths of stay was obtained from the Canadian Institute for Health Information database. Results: The average length of stay decreased from 25 days to 16 days, reaching the national level at one hospital. An initial increase in the readmission rate subsequently declined to pre-study levels. There was no change in length of stay at the other hospital. Conclusion: Reducing the length of stay in an acute care facility by 9 days to an average of 16 days did not lead to a sustained increase in the readmission rate.

Paliperidone Palmitate Study in Patients With Personality Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S505-S505
Author(s):  
M.A. Gutierrez Ortega ◽  
D.P. María Dolores ◽  
M.A. Manuel ◽  
M.M. Esther
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Hospital Admissions ◽  
Average Length ◽  
Paliperidone Palmitate ◽  
Emergency Visits ◽  
Actual Clinical Practice ◽  
Average Length Of Stay ◽  
Psychopharmacological Treatment ◽  
Competing Interest

IntroductionPersonality disorders are chronic affectation of mood, impulsivity, aggression and anxiety. It is thought to have biological factors related to the development of personality disorders.AimsTo evaluate and compare the efficacy of injectable paliperidone in actual clinical practice of patients diagnosed with Personality Disorder, compared to other treatments.MethodsWe conducted a descriptive, restrospective and observational study from January 2012 to June 2015 including all the patients who are treated with paliperidone palmitate extended-release injectable suspension with a diagnosis of Personality Disorder according to DSM 5. We included patients with at least 12 months of treatment and the results were compared with respect to the 12 months prior to taking said drug. Variables studied: medical diagnosis, hospital admissions, average length of stay, total number of emergency visits or other devices, maintenance doses.ResultsWe recruited 14 patients (7 women and 7 men) with a mean age of 36.2. 64.29% of patients had borderline personality disorder; 21.43% unspecified personality disorder. The mean dose of maintenance treatment is 105.357. Before the treatment, the quantity of total number of hospital admission are 1.14 versus 0.429 after treatment. The number of stay is also decreased from 13.7 to 3.5; like emergency room visits or to other devices. 78.57% of patients continue to psychopharmacological treatment. Fifty percent of patients undergoing treatment with another antipsychotic (P < 0.05).ConclusionsThe present results show that paliperidone palmitate can be an effective way to control the most characteristic symptoms of Personality Disorders, and reducing emergency visits, hospitalisations and other devices.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Malignant Neoplasms of Bone and Articular Cartilage –Hospital Burden in Romania

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 43
Author(s):  
D.G. Mincă ◽  
C. Cîrstoiu ◽  
F.L. Furtunescu ◽  
R.V. Costea
Keyword(s):  
Articular Cartilage ◽  
Average Length ◽  
Global Analysis ◽  
Age Groups ◽  
Malignant Neoplasm ◽  
National Registry ◽  
Malignant Neoplasms ◽  
Average Length Of Stay ◽  
Duration Of Hospitalization ◽  
Reported Data

Abstract Introduction. Cancers of bone and articular cartilage are relatively rare, and a global analysis was not performed up to present in Romania due to the lack of a national registry for these diseases. This study aimed to explore the hospital burden due to malignant neoplasm of bone and articular cartilage in Romania and the general characteristics of the hospitalized cases. Materials and methods. We used the data reported in the routine statistic system during 2012 and 2016 and we analyzed the number of cases discharged from hospitals by age group, gender, and duration of hospitalization. Results. The number of hospitalized cancers of bone and articular cartilages decreased by 17% in the last five years (2012-2016) but this decrease was higher in other/ unspecified cancers (22%) and lower in limb cancers (10%). Among the 1872 cases reported in 2016, 47% were limbs’ cancers and the rest, cancers of others/ unspecified sites. Males accounted for 62% of all cancers (58% of limbs cancers and 65% of other cancers, p=0.001, Chi2 test). Distribution by age showed that 17%, 62% and 21% of the cancers occurred in age-groups 0-14, 15-64 and 65+ respectively, but limbs cancers occurred in a significantly higher proportion in children (29% vs. 7% of other cancers, p<0.001). 16983 days of hospitalization were reported in 2016 for this pathology, with an average length of stay of 9.07 days (9.37 and 8.81 days in limbs and other cancers respectively). Conclusions. More detailed analysis of routine reported data is required for understanding the characteristics and trends of bone cancers in Romania.

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