Length of Stay of Orthopaedic Inpatients at a Teaching Hospital in Eastern Part of Nepal

Mishra, Bibhuti; Jha, Anuja; Maharjan, Era; Limbu, Mahima; Sah, Saroj; Gupta, Yogendra Kumar; Jha, Ranjib Kumar; Sitoula, Prakash

doi:10.31729/jnma.2787

Cited by 8 publications

(6 citation statements)

References 2 publications

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“…The median length of stay observed in this study was longer compared to literature from the developed world 26 but consistent with data from the developing world 22,24,27 . A possible explanation based on our experience could be due to little emphasis on cost effective care and resources miss match resulting in prolonged hospital stay and delay in accessing supporting services such as radiology, physiotherapy and laboratory.…”

Section: Discussionsupporting

confidence: 89%

Epidemiology and medical costs of orthopedic conditions in a tertiary hospital in Kenya; A five-year analysis of admission data

Kihuba

2022

Preprint

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Background: Orthopedic services are a key component of the surgical healthcare system. Scaling up these services would not only reduce the musculoskeletal diseases burden but also the overall disease burden significantly. As such quality intelligence on epidemiology and costs of orthopedic services should be accurately represented for guiding effective policy formulation and implementation. Aim: The aim of the study was to provide a snapshot of the pattern of orthopedic admissions, care and associated medical costs in Kenya. Methods: A retrospective study was conducted reviewing case files of patients admitted to the orthopedic department from 1st January 2015 to 30st November 2019. Results: There were 4320 distinct musculoskeletal admission diagnoses among the 3527 admissions. The study shows that trauma accounts for 53.04% of all admissions while joint replacement, shoulder and knee, limb deformities, infection, removal of hardware, ankle and foot and tumour procedures accounts for 15.01%, 8.87%, 7.29%, 6.44%, 3.94% and 3.23% respectively. Joint replacement is the leading diagnosis among patients in the 61 to 75 years age group and fragility fractures and posttraumatic arthritis featured prominently as the key reasons for joint reconstruction. The proportion of admissions with health insurance (60.82%) was exceptionally high compared to the national average (19.59%). However, current financing mechanism provide inadequate social protection against cost of orthopaedic surgery. Conclusion: The case volume and mix highlight the growing importance of trauma, fragility fractures and degenerative joint diseases in orthopaedic care in developing country set up. Overall, the observed model of care and associated outcome and costs provide a blueprint for orthopaedic system development.

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Section: Discussionsupporting

confidence: 89%

Epidemiology and medical costs of orthopedic conditions in a tertiary hospital in Kenya; A five-year analysis of admission data

Kihuba

2022

Preprint

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“…Please cite this article as: Günay The expected duration of hospitalization was 3.2 days whereas the average daily hospitalization was 16.3 patients. While the average duration of hospitalization was found to be 10.5 days in a previous study conducted in Nepal (7). In another study performed by Gholson et al (8) in USA the duration of hospital stay in total knee and hip arthroplasty surgeries was found as 3.2 days.…”

Section: Discussionmentioning

confidence: 82%

Distribution of Orthopedic Surgery Interventions Evaluation of 6236 Cases

Günay¹

2021

Erciyes Med J

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“…In addition, patients admitted for orthopaedic attention had the longest average LoS (28 days), with some staying up to 57 days without any remarkable work-up. A study in Nepal [9] reported that an average LoS for orthopaedic inpatients at a tertiary hospital was 10.5 days. [9] A SA report on the burden and profile of spinal pathology in Cape Town recorded a median hospital stay of 19 days.…”

Section: Discussionmentioning

confidence: 99%

“…A study in Nepal [9] reported that an average LoS for orthopaedic inpatients at a tertiary hospital was 10.5 days. [9] A SA report on the burden and profile of spinal pathology in Cape Town recorded a median hospital stay of 19 days. [10] The average LoS was 7 days in the Department of General Surgery.…”

Section: Discussionmentioning

confidence: 99%

Audit of surgical specialty patients and beds at Pietersburg Hospital, Limpopo Province, South Africa in 2021

Mavhungu

Jonas

2021

S Afr Med J

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Hospital beds are in great demand all over the world. [1] Hospital beds are expensive; in South Africa (SA), the ballpark figure per bed per year is ZAR1 million for secondary hospitals and ZAR2 million per year for academic hospitals. Hospital managers are therefore generally pressurised to keep the total number of beds as low as possible. Although the absolute number of beds is usually discussed, the precise utilisation of the beds is often neglected. This is a huge oversight if patients are kept unnecessarily admitted, and drives the costs enormously. There are obvious competing demands for beds by the non-cutting and cutting (surgical) specialties, and decisions around this are typically political and philosophical.According to the World Health Organization, ~2 billion people around the world are estimated to have inadequate access to surgical care. [2] Surgical care is an integral part of health systems worldwide. However, delays due to multiple transfers of surgical patients are common, even in developed countries. [3][4][5] Pietersburg Hospital (PH) is a teaching hospital for the University of Limpopo, which is 31.5 km east of Polokwane city, the provincial capital. The hospital serves as the referral hospital for regional and district hospitals in the province. The hospital has 196 beds set aside for all adult surgical patients. Most of the beds (128) are reserved for male patients, while female patients have 68 beds. Various surgical specialties are responsible for bed allocation.The audit reported in the present study is the first to describe the actual surgical specialty bed utilisation and the average length of stay (LoS) at a tertiary hospital in Limpopo Province, SA. In this hospital, patients are allocated to wards where beds are available, even if it is not the correct unit under which the patient should receive treatment. In an ideal situation, patients should be followed up and transferred to the correct ward as soon as a bed becomes available. If not, beds are unnecessarily occupied and this creates delay for those patients still awaiting hospital care and clinical procedures. [6] Patients are often denied acute surgical management due to unavailability of beds. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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Length of Stay of Orthopaedic Inpatients at a Teaching Hospital in Eastern Part of Nepal

Cited by 8 publications

References 2 publications

Epidemiology and medical costs of orthopedic conditions in a tertiary hospital in Kenya; A five-year analysis of admission data

Epidemiology and medical costs of orthopedic conditions in a tertiary hospital in Kenya; A five-year analysis of admission data

Distribution of Orthopedic Surgery Interventions Evaluation of 6236 Cases

Audit of surgical specialty patients and beds at Pietersburg Hospital, Limpopo Province, South Africa in 2021

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