Measuring medically unjustified hospitalizations in Switzerland

Eggli, Yves; Halfon, Patricia; Piaget-Rossel, Romain; Bischoff, Thomas

doi:10.1186/s12913-022-07569-3

Cited by 3 publications

(1 citation statement)

References 43 publications

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“…Second, despite the regular use of PAH as internationally standardized indicators for interpreting the quality of primary care, elevated rates of ambulatory-care-sensitive conditions might be associated with heterogeneous approaches for hospital admission criteria and locally accepted procedures and finally not related to the ambulatory care itself [37]. This is one of the limitations of using PAH as a quality indicator that has been driving research in this field, aiming to improve its pertinence and clinical relevance [38]. Third, no adjustments were made to the regional healthcare supply, whether in terms of hospital care or primary care physicians, or to socioeconomic indicators, or even disease prevalence.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Potentially Avoidable Hospitalizations by Asthma and COPD in Switzerland from 1998 to 2018: A Cross-Sectional Study

2023

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Potentially avoidable hospitalizations (PAH) are commonly used as an indicator for healthcare quality and primary care performance. However, data are usually presented in a restricted timeframe and for a specific region, limiting the identification of trends and national patterns. We aimed in this study to calculate rates, identify clinical determinants, and estimate costs of PAH for two frequent lung diseases (asthma and COPD) in Switzerland between 1998 and 2018 using hospital discharge data available for patients aged ≥20 years. PAH were defined according to the Health Care Quality Indicators Project (HCQIP) from the Organisation for Economic Co-operation and Development (OECD). The distribution of PAH in seven administrative regions (Leman, Mittelland, Northwest, Zurich, Eastern, Central, and Ticino) was calculated, along with PAH-associated total hospital days and Diagnosis-Related Group (DRG) estimated costs. Totals of 25,260 PAH for asthma and 135,069 PAH for COPD were identified in the 20-year period. The standardized rates of PAH per 100,000 people for asthma fluctuated from 18.7 in 1998 to 22.5 on 2018. The standardized rates of PAH per 100,000 people from COPD almost doubled from 77.4 in 1998 to 142.7 in 2018. In 2018, the estimated total costs of PAH amounted to 7.7 million CHF for asthma and 91.2 million CHF for COPD. We conclude that PAH for asthma and COPD represent a significant and unnecessary burden and costs of hospitalizations in Switzerland.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Potentially Avoidable Hospitalizations by Asthma and COPD in Switzerland from 1998 to 2018: A Cross-Sectional Study

2023

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Impact of a dedicated radial lounge on same‐day discharge percutaneous coronary intervention

Liberman,

Botto,

Benzadon

et al. 2024

Cathet Cardio Intervent

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BackgroundThe same‐day discharge (SDD) program after elective percutaneous coronary intervention (PCI) is a safe strategy that allows for the optimization of hospital resources. However, the lack of adequate infrastructure and a specially targeted care model may limit its implementation. Our center developed an outpatient care model based on an area designed for percutaneous procedures called radial lounge (RL).AimsEvaluate the efficacy and safety of the RL care model: (1) SDD rate, (2) patient experience, (3) major adverse cardiac events (MACEs) (in‐hospital, 30‐day, and 1‐year mortality and intervention), and (4) vascular access complication. Secondary objective: Impact of RL SDD rate on total elective SDD‐PCI volume.MethodsWe conducted a retrospective observational cohort study at a cardiovascular hospital, including consecutive patients undergoing elective PCI between 2015 and 2022 who were admitted to the conventional hospitalization area (CHA) or the RL about the stated objectives. Patient experience was assessed using the Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.ResultsA total of 5466 elective PCI procedures were included: 2102 in the RL and 3364 in the CHA. The SDD rate was 85.2% in the RL group and 54% in the CHA. After the implementation of RL, a significant increase in the volume of elective SDD‐PCI was observed and patient satisfaction improved significantly (p < 0.005) with CHA. Finally, a greater amount of MACEs were not observed in the RL.ConclusionsThe PCI program in RL proved to be safe and effective. It showed a higher rate of SDD and a significant improvement in patient experience was observed without affecting safety.

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Dermatological emergencies and determinants of hospitalization in Switzerland: A retrospective study

Cazzaniga,

Heidemeyer,

Zahn

et al. 2024

Acad Dermatol Venereol

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BackgroundDermatologic conditions are estimated to account worldwide for approximately 8% of all visits at emergency departments (EDs). Although rarely life‐threatening, several dermatologic emergencies may have a high morbidity. Little is known about ED consultations of patients with dermatological emergencies and their subsequent hospital disposal.ObjectiveWe explore determinants and clinical variables affecting patients' disposal and hospitalization of people attending the ED at a Swiss University Hospital, over a 56‐month observational period, for a dermatological problem.MethodsDe‐identified patients' information was extracted from the hospital electronic medical record system. Generalized estimating equations were used to explore determinants of patient's disposition.ResultsOut of 5096 consecutive patients with a dermatological main problem evaluated at the ED, 79% of patients were hospitalized after initial assessment. In multivariable analyses, factors which were significantly associated with an increased admission rate included length of ED stay, age ≥ 45 years, male sex, distinct vital signs, high body mass index, low oxygen saturation, admission time in the ED and number and type of dermatological diagnoses. Only 2.2% of the hospitalized patients were admitted to a dermatology ward, despite the fact that they had dermatological diagnoses critically determining the diagnostic related group (DRG) payment. The number of patients managed by dermatologists during in‐patient treatment significantly decreased over the study period.ConclusionsOur study identifies a number of independent predictors affecting the risk of hospital admission for patients with dermatological conditions, which may be useful to improve patients' disposal in EDs. The results indicate that the dermatological specialty is becoming increasingly marginalized in the management of patients in the Swiss hospital setting. This trend may have significant implications for the delivery of adequate medical care, outcomes and cost‐effectiveness. Dermatologists should be more engaged to better position their specialty and to effectively collaborate with nondermatologists to enhance patient care.

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Measuring medically unjustified hospitalizations in Switzerland

Cited by 3 publications

References 43 publications

Potentially Avoidable Hospitalizations by Asthma and COPD in Switzerland from 1998 to 2018: A Cross-Sectional Study

Potentially Avoidable Hospitalizations by Asthma and COPD in Switzerland from 1998 to 2018: A Cross-Sectional Study

Impact of a dedicated radial lounge on same‐day discharge percutaneous coronary intervention

Dermatological emergencies and determinants of hospitalization in Switzerland: A retrospective study

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