Characteristics of short general internal medicine hospital stays: a multicentre cross-sectional study

Abstract

H ospital care accounts for nearly 30% of health care costs in Canada. 1 Given the high costs of hospital care, there is substantial interest in averting unnecessary hospital admissions and reducing length of stay. Interventions designed to avoid admission 2 or reduce the length of stay have included hospital-at-home, 3 short-stay or observation units, 4-8 and rapid-access clinics. 9 Patients with short stays may be candidates for these models of expedited and streamlined care. Patient age, illness severity, level of comorbidity and functional status have all been associated with longer hospital stays. 10-16 However, less is known about the situational and phys ician factors and resource use associated with short medical stays. The proportion of medical admissions associated with a short stay and the conditions that account for these short stays are also not well described. This information may highlight opportunities to improve care. To inform the design of interventions that target patients with potentially avoidable hospital admissions or brief stays, we examined the patient, physician and situational characteristics associated with short stays among patients admitted to general internal medicine wards. In addition, we describe the use of hospital resources by these patients. Methods Design, setting and participants This was a multicentre cross-sectional study involving 5 academic hospitals in Toronto that were participating in the General Medicine Inpatient Initiative (GEMINI). 17 The participating sites included St.

Effects of multimedia‐based fall prevention education on the knowledge, attitudes, or behaviors of patients

“…Furthermore, their primary caregivers were mainly family members, and most of the patients did not read the health education leaflets. In a study by Verma et al (2019), the majority of internal medicine inpatients were aged between 63 and 74 years, which is similar to the finding for the inpatients in this study. As a result of aging, individuals may experience insufficient bone and muscle control, lower extremity weakness, balance deficiencies, and an unsteady gait; thus, falls are likely to occur (Bridewell, 2020).…”

Appropriateness of peripherally inserted central catheter use among general medical inpatients: an observational study using routinely collected data

“…Therefore, we excluded 579 PICC placements from the institution during that time (representing 12% of all PICC placements). General medicine patients in participating hospitals have previously been described in detail 10–12. They represent nearly 40% of emergency department admissions and 25% of hospital bed days and are broadly similar to other general medicine inpatient populations in Canada, Europe and the USA 10…”

Modelling resource requirements and physician staffing to provide virtual urgent medical care for residents of long-term care homes: a cross-sectional study

“…We focused here on patients with admissions less than or equal to 72 hours rather than those with admissions longer than 72 hours on the basis of previous definitions in the literature for short stay units and avoidable admissions. 15,16…”

“…Prior attempts to provide proxies for avoidability have used measures such as ambulatory care sensitive conditions, low-acuity admissions or short admissions. 15,18 We provide an upper bound on the total resources that may be required, but it is unlikely that all of these patients truly represent avoidable transfers. Our models are based on admissions to general medicine whereas many transfers from LTC facilities to hospital may be for issues like injuries requiring other types of physician or nonphysician services.…”