Influence of prolonged hospitalization on overall bed occupancy: a five-year single-centre study

Quinn, Michael; Courtney, Aisling E.; Fogarty, Damian; O’Reilly, Dermot; Cardwell, Christopher; McNamee, P

doi:10.1093/qjmed/hcm064

Cited by 6 publications

(8 citation statements)

References 5 publications

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“…All admissions data for the period 1 January 2001 to 31 December 2005 were obtained from the PAS system; hospital number, date of birth and age, postcode, gender, admission date, admission unit, mode of admission, diagnoses, date of discharge, and mode of discharge were recorded. The full interrogation details of this database have previously been described 17. Diagnoses were coded using the International Classification of Diseases (ICD) 10 code; each admission episode had a primary, secondary, and up to five additional diagnoses.…”

Section: Methodsmentioning

confidence: 99%

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Patterns of hospitalisation before and following initiation of haemodialysis: a 5 year single centre study

Quinn

Cardwell

Rainey

et al. 2011

Postgraduate Medical Journal

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BACKGROUND The utilisation of healthcare resources by prevalent haemodialysis patients has been robustly evaluated with regard to the provision of outpatient haemodialysis; however, the impact of hospitalisation among such patients is poorly defined. Minimal information is available in the UK to estimate the health and economic burden associated with the inpatient management of prevalent haemodialysis patients. The aim of this study was to assess the pattern of hospitalisation among a cohort of haemodialysis patients, before and following their initiation of haemodialysis. In addition the study sought to assess the impact of their admissions on bed occupancy in a large tertiary referral hospital in a single region in the UK. METHODS All admission episodes were reviewed and those receiving dialysis with the Belfast City Hospital Programme were identified over a 5 year period from January 2001 to December 2005. This tertiary referral centre provides dialysis services for a population of approximately 700 000 and additional specialist renal services for the remainder of Northern Ireland. The frequency and duration of hospitalisation, and contribution to bed day occupancy of haemodialysis patients, was determined and compared to other common conditions which are known to be associated with high bed occupancy. In addition, the pattern and timing of admissions in dialysis patients in relation to their dialysis initiation date was assessed. RESULTS Over the 5 year study period, 798 haemodialysis patients were admitted a total of 2882 times. These accounted for 2.5% of all admissions episodes; the median number of admissions for these patients was 3 (2-5) which compared with 1 (1-2) for non-dialysis patients. The majority of first hospitalisations (54%) were within 100 days before or after commencement of maintenance dialysis therapy. In all clinical specialties the median length of stay for haemodialysis patients was significantly longer than for patients not on haemodialysis (p=0.004). In multivariate analysis with adjustment for age, gender, and other clinically relevant diagnostic codes, maintenance haemodialysis patients stayed on average 3.75 times longer than other patient groups (ratio of geometric means 3.75, IQR 3.46-4.06). CONCLUSIONS Maintenance haemodialysis therapy is an important risk factor for prolonged hospitalisation regardless of the primary reason for admission. Such patients require admission more frequently than the general hospital population, particularly within 100 days before and after initiation of their first dialysis treatment.

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Section: Methodsmentioning

confidence: 99%

“…To facilitate further analysis we grouped specific ICD codes using a procedure identical to that previously described 17. Defined categories were described based on the presence of certain conditions as evidenced by the primary, secondary, and subsidiary ICD diagnoses.…”

Section: Methodsmentioning

confidence: 99%

Patterns of hospitalisation before and following initiation of haemodialysis: a 5 year single centre study

Quinn

Cardwell

Rainey

et al. 2011

Postgraduate Medical Journal

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“…Full details of dataset construction have previously been described in depth [3]. In summary the BCH Patient Administration System (PAS) was interrogated to provide all admission data for the period 1 January 2001 to 31 December 2005.…”

Section: Methodsmentioning

confidence: 99%

“…For further analysis, a LOS exceeding 30 days was considered as a prolonged admission. Our previous analysis identified 30 days as the 95 th percentile with regard to the LOS amongst all BCH admissions; analysis of bed occupancy amongst prevalent ESRD patients in the United States also used this period to define lengthy hospitalization [3, 6]. …”

Section: Methodsmentioning

confidence: 99%

“…One such strategy is aimed at reducing the mean length of stay (LOS) of patients admitted to a hospital, with comparative evidence that those with similar diagnoses in the United States are hospitalised for shorter time periods [2]. Our previous work suggested that targeting resources to those patients with very prolonged admissions would further improve overall efficiency [3]. …”

Section: Introductionmentioning

confidence: 99%

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The Impact of Admissions for the Management of End-Stage Renal Disease on Hospital Bed Occupancy

Quinn

Cardwell²,

Rainey

et al. 2009

Nephron Clin Pract

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Background: End-stage renal disease (ESRD) is increasingly prevalent but the inpatient costs associated with this condition are poorly defined due to limitations with data extraction and failure to differentiate between hospitalisation for renal and non-renal disease reasons. The impact of admissions primarily for the management of ESRD on hospital bed utilisation was assessed over a 5-year period in a large teaching hospital. Methods: All admission episodes were reviewed and the ESRD group was identified by a primary International Classification of Diseases code for ESRD or a non-specific primary renal failure code with a secondary code for ESRD. The frequency and duration of hospitalisation and contribution to bed day occupancy of this group with ESRD was determined. Results: There were 70,808 patients responsible for a total of 116,915 admissions and 919,212 bed days over the study period. Of these, 988 (1.4%) patients were admitted for the management of ESRD, accounting for 2,387 (2.0%) of admissions and utilisation of 23,011 (2.5%) bed days. After adjustment for age and gender, those admitted for ESRD management were significantly more likely to have a prolonged admission exceeding 30 days (odds ratio 1.46, 95% confidence interval 1.23–1.72, p < 0.001). When the admission was an emergency rather than an elective event, the patient was 4.6 times more likely to be hospitalised for over 30 days. Conclusions: Persons admitted for ESRD management are hospitalised more frequently and for longer than the overall inpatient population, occupying a substantial number of bed days.

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SHARP risk score: A predictor of poor outcomes in adults admitted for emergency general surgery: A prospective cohort study

Tanos

Ablett

Carter

et al. 2023

Asian Journal of Surgery

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Influence of prolonged hospitalization on overall bed occupancy: a five-year single-centre study

Abstract: Prolonged hospitalizations have a significant impact on bed occupancy. Targeting these very long (>100 days) hospital stays may better improve overall efficiency, compared to targeting mean or median length of stay.

Cited by 6 publications

References 5 publications

Patterns of hospitalisation before and following initiation of haemodialysis: a 5 year single centre study

Patterns of hospitalisation before and following initiation of haemodialysis: a 5 year single centre study

The Impact of Admissions for the Management of End-Stage Renal Disease on Hospital Bed Occupancy

SHARP risk score: A predictor of poor outcomes in adults admitted for emergency general surgery: A prospective cohort study

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