Comparison of Length of Stay for Asthma by Hospital Type

Samuels, Barbara N.; Novack, Alvin H.; Martin, Diane P.; Connell, Frederick A.

doi:10.1542/peds.101.4.e13

Cited by 27 publications

(18 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although advanced adjustments were made in this study for complications or comorbidities, there was no plausible method for ensuring that all sampled patients had the same unmeasured severity of illness. Our interpretation, however, is supported by Samuels et al's study which indicated that 'adverse case mix/severity of illness' was a major contributory factor to the variations in LOS between hospitals (Samuels et al 1998). The study by Yimtae et al (2001) also demonstrated that the severity of hearing loss significantly influenced the prognosis for patients suffering from SSNHL.…”

Section: Discussionsupporting

confidence: 64%

Physician and Hospital Characteristics Related to Length of Stay for Sudden Sensorineural Hearing Loss Patients

Chao

Lin

2008

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

The treatment of sudden sensorineural hearing loss (SSNHL) has remained one of the most controversial issues in otolaryngology, and there are wide disparities between clinicians' treatment methods for SSNHL. Using five-year population-based data, we explored the relationship between physician and hospital characteristics and the length of stay (LOS) for SSNHL patients in Taiwan. The dataset was derived from the National Health Insurance Research Database. The patients in the study sample were identified by a principal diagnosis of sudden hearing loss. A total of 8712 hospitalization cases between 1998 and 2002 inclusive were included. Multiple regression analyses were performed in order to explore the relationship between physician and hospital characteristics and LOS, adjusting for patients' age and gender, as well as complications or comorbidities. The mean LOS for the duration of the study period was 5.62 days, while the regression analysis showed that, as compared to district hospitals, the LOS in medical centers and regional hospitals was 0.42 and 0.37 days longer, respectively (all p < 0.001). The analysis also revealed that the LOS was 0.71 days shorter for patients who were attended by physicians specializing in otolaryngology than for those attended by physicians specializing in other areas ( p < 0.001). This study concludes that there is indeed a relationship between physician and hospital characteristics and the LOS for SSNHL patients. The results of this study serve to highlight the importance of developing treatment protocols for SSNHL so as to reduce the variation in physician or hospital behavior. length of stay; sudden sensorineural hearing loss; hospital characteristics. Tohoku

show abstract

Section: Discussionsupporting

confidence: 64%

Physician and Hospital Characteristics Related to Length of Stay for Sudden Sensorineural Hearing Loss Patients

Chao

Lin

2008

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…These findings are in line with several previous studies, 12,18,35,36 and are likely due to multiple factors that may include worse disease severity on presentation. 37 Additional research is necessary to understand whether there are differences in processes of care, quality of care, or other outcomes related to inpatient management for children with different insurance coverage.…”

Section: Discussionsupporting

confidence: 93%

Risk Factors for Prolonged Length of Stay or Complications During Pediatric Respiratory Hospitalizations

Kaiser

Bakel

Okumura

et al. 2015

Hospital Pediatrics

View full text Add to dashboard Cite

A B S T R A C T BACKGROUND AND OBJECTIVES:Respiratory illnesses are the leading cause of pediatric hospitalizations in the United States, and a major focus of efforts to improve quality of care. Understanding factors associated with poor outcomes will allow better targeting of interventions for improving care. The objective of this study was to identify patient and hospital factors associated with prolonged length of stay (LOS) or complications during pediatric hospitalizations for asthma or lower respiratory infection (LRI). METHODS:Cross-sectional study of hospitalizations of patients ,18 years with asthma or LRI (bronchiolitis, influenza, or pneumonia) by using the nationally representative 2012 Kids Inpatient Database. We used multivariable logistic regression models to identify factors associated with prolonged LOS (.90th percentile) or complications (noninvasive ventilation, mechanical ventilation, or death). CONCLUSIONS: Older children with asthma, younger children with LRI, children with chronic conditions, and those hospitalized in large urban-teaching hospitals are more vulnerable to prolonged LOS and complications. Future research and policy efforts should evaluate and support interventions to improve outcomes for these high-risk groups (eg, hospital-based care coordination for children with chronic conditions). RESULTS:

show abstract

“…The viability of many teaching hospitals is threatened by competitive health care market forces and by potential reductions in federal financing of graduate medical education. 15 In particular, independent children's teaching hospitals that receive minimal federal Medicare graduate medical education funding are threatened by ever-tightening reimbursement (P. Willson, personal communication, National Association of Children's Hospitals and Related Institutions, 1988).…”

Section: Hospital Location and Teaching Statusmentioning

confidence: 99%

Charges for Childhood Asthma by Hospital Characteristics

Meurer¹,

Kuhn²,

George³

et al. 1998

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Background. The ownership, location, and teaching status of hospitals affect their missions, policies, finances, and operations.Objective. This study assesses the relationship of hospital ownership, location, and teaching status with charges and length of stay for children with asthma, the most common reason for pediatric admission after birth.Methods. All 28 545 complete records of patients <18 years of age with the principal diagnosis asthma in 1994 were extracted from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, providing a stratified sample of 735 nonfederal, acute-care hospitals in 17 states. Multiple regression analysis on log transformed data was used to calculate mean total charges and average length of stay (ALOS) after adjusting for illness severity and mortality risk (four All Patient Refined-Diagnosis Related Group classes based on secondary diagnoses and procedures); payer (Medicaid, private, uninsured, other); patient age, sex, income (four categories based on ZIP code of residence); state; bed size (three categories varying by location); hospital ownership; location; teaching status; and admission month.Results. Asthma severity did not differ significantly by hospital location or teaching status. Nonprofit hospitals treated a slightly higher proportion of children with major or extreme severity asthma than either public or for-profit hospitals. Urban teaching hospitals treated more children with asthma who lived in low-income neighborhoods, were uninsured, or received Medicaid coverage than urban nonteaching hospitals. For-profit hospitals admitted fewer children with asthma from lowincome areas than did public hospitals. The ALOS was 2.5 days and did not differ significantly by hospital ownership, location, or teaching status. However, the mean total charges, after adjusting for all other significant covariates, was higher at for-profit ($4203) than at nonprofit ($3640) or public hospitals ($3620). Average charges also were higher at urban teaching ($4230) and lower at rural institutions ($2910) compared with urban nonteaching hospitals ($3424).Conclusions. Despite similar ALOS, mean charges for childhood asthma varied significantly by hospital ownership, location, and teaching status.Implications. Additional clinical and outpatient data are needed to study variations in quality of care by hospital characteristics. With the proliferation of investorowned hospitals, both the reasons for and the impact of higher average charges at for-profit institutions require additional investigation. With the expanding needs of the medically underserved, socially just policies are required for financing hospitals that care for a disproportionate share of economically disadvantaged children. Pediatrics 1998;102(6). URL: http://www.pediatrics.org/ cgi/content/full/102/6/e70; hospital charges, length of stay, asthma, community hospitals, severity of illness index. H ospital charges are based in part on the fixed costs of maintaining a hospital, the marginal costs of caring for...

show abstract

Comparison of Length of Stay for Asthma by Hospital Type

Cited by 27 publications

References 28 publications

Physician and Hospital Characteristics Related to Length of Stay for Sudden Sensorineural Hearing Loss Patients

Physician and Hospital Characteristics Related to Length of Stay for Sudden Sensorineural Hearing Loss Patients

Risk Factors for Prolonged Length of Stay or Complications During Pediatric Respiratory Hospitalizations

Charges for Childhood Asthma by Hospital Characteristics

Contact Info

Product

Resources

About