The health cost of reducing hospital bed capacity

Siverskog, Jonathan; Henriksson, Martin

doi:10.1016/j.socscimed.2022.115399

Cited by 12 publications

(4 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, our hypothesis seems correct, and HPN was cost saving. In the present study, it was associated with a 32% reduction in costs when comparing the same patient´s at last week of hospital stay with their rst week on HPN, mostly due to avoiding hospital bed costs (33)(34)(35). A 36% cost-saving result is found when comparing 1 month of HPN against an estimated cost of 1 month of Hospital PN (in the hypothetical situation the patient remains in the hospital solely to receive PN).…”

Section: Discussionmentioning

confidence: 58%

Cost Savings of Home Parenteral Nutrition Compared to Hospital Parenteral Nutrition: A Multicentre Prospective Analysis

Martinuzzi,

Crivelli,

Flores

et al. 2024

Preprint

View full text Add to dashboard Cite

BACKGROUND Parenteral nutrition (PN) is a safe and effective type of nutrition support. Several publications demonstrate the impact of Home Parenteral Nutrition (HPN) reducing health care costs. The question is, are HPN practices in Latin America also cost saving when compared with hospital PN? This study aimed to compare the direct costs of healthcare and non-healthcare of HPN to Hospital PN costs in Argentina through a prospective, analytical, and longitudinal, multicentre non-interventional study. MATERIALS AND METHODS Adult Patients with PN were included and followed during the last week of Hospital PN (Week − 1 before discharge), through the first week of HPN (Week + 1), and until the first month of HPN (Month + 1). Clinical, nutritional, and cost variables were recorded. Continuous variables (mean ± SD or median Q1–Q3), were tested whit T-tests or Wilcoxon signed rank test. Categorical (frequencies and percentages) were tested with the McNemar test. The total direct cost (Total Direct healthcare cost + Total Direct non-healthcare cost) from Hospital PN Week − 1 was compared with HPN Week + 1. Additionally, HPN Month + 1 was compared with an estimate of the total costs of Hospital PN Month − 1. A difference was considered significant with a two-sided p-value < 0.05. Statistical analysis was performed using IBM-SPSS 26. RESULTS Forty-four patients met the inclusion/exclusion criteria and were included for analysis. Comparing HPN Week + 1 vs Hospital PN Week − 1. HPN was associated with lower total direct healthcare costs (HPN U$S 2.863,1+/-633,1 vs Hospital PN U$S 4.361,2+/-743,1. P < 0,001 Mean Difference U$S − 1.498,1 CI 95% -1.203,2 : -1.789,9). Lastly, the total direct cost (healthcare and non-healthcare) was lower in the HPN setting vs. the Hospital setting for 1 week (U$S 2.987,4+/-639 vs. 4439,8+/-761,5 P < 0.001 Mean Difference U$S -1.452,0 CI 95% -1.756,28 : -1.148,4). The cost reduction of HPN for 1 week was 32% (20.3% − 42.8%) and for 1 month was 36% (27.5% − 48.5%). CONCLUSIONS: HPN is cost saving compared to Hospital PN. The major cause of this cost reduction is mostly related to direct Healthcare costs.

show abstract

Section: Discussionmentioning

confidence: 58%

Cost Savings of Home Parenteral Nutrition Compared to Hospital Parenteral Nutrition: A Multicentre Prospective Analysis

Martinuzzi,

Crivelli,

Flores

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Hospitals with medium and large bed sizes tended to have a higher chance of survival compared to those with a small bed size. Unlike hospitals in other high-income countries [50], inpatient care in hospitals with smaller bed sizes contributed to a lower death risk for pediatric clinical trial patients [50].…”

Section: Discussionmentioning

confidence: 99%

Predicting risk factors for pediatric mortality in clinical trial research: A retrospective, cross-sectional study using a Healthcare Cost and Utilization Project database

Ma,

Johnson,

McCrory

2023

J. Clin. Trans. Sci.

View full text Add to dashboard Cite

Introduction: Incorporating real-world data using “big data” analysis in healthcare are useful to extract specific information for healthcare delivery system improvement. All-cause mortality is an essential measure to enhance patient safety in clinical trial research, especially for underrepresented pediatric participants. Objective: This study aimed to determine the associations between pediatric mortality and patient-specific factors using the Healthcare Cost and Utilization Project (HCUP) database. Methods: Data from the 2019 the HCUP Kids’ Inpatient Database (KID) were used to conduct a logistic regression analysis to determine associations between pediatric patients’ the chance of survival and their demographic and socioeconomic background, discharge records, and hospital information. Results: Total number of diagnoses (OR = 0.84), total number of procedures (OR = 0.86), length of stay (OR = 1.04), age intervals greater than 1 year (OR > 1.0), transfer into the hospital from a different acute care (OR = 0.34), major diagnoses of multiple significant trauma (OR = 0.03) or hepatobiliary system and pancreas (OR = 0.10), region of hospital – west and midwest (OR > 1.0), and medium or larger hospital bed size (OR > 1.0) were all significantly associated with the chance of survival for patients participating in pediatric clinical trials (p < 0.05). Conclusion: Real-world clinical trial data analysis showed the potential improvement area including reallocating trial resources to promote trial quality and safe participation for pediatric patients. Pediatric trials need tools that are developed using user-centered design approaches to satisfy the unique needs and requirements of pediatric patients and their caregivers. Safe intrahospital transfer procedures and active dissemination of successful trial best practices are crucial to trial management, adherence, quality, and safety.

show abstract

“…To improve patient turnover and release hospital beds, feedback systems between hospitals and bed capacity control systems has proven to be a remedy 47 . However, in Beveridge-like health care systems like the one in Sweden, such remedies are either rare or insufficient 48 . In Sweden a slow hospital throughput is known to be an effect of staff shortage, and poor incentives to improve the bed capacity.…”

Section: Discussionmentioning

confidence: 99%

Fast track to stroke unit for patients not eligible for acute intervention, a case–control register study on 1066 patients

Wennman,

Wijk,

Jood

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Stroke patients not eligible for acute intervention often have low priority and may spend long time at the emergency department (ED) waiting for admission. The aim of this retrospective case–control register study was to evaluate outcomes for such “low priority” stroke patients who were transported via Fast Track directly to the stroke unit, according to pre-specified criteria by emergency medical service (EMS). The outcomes of Fast Track patients, transported directly to stroke unit (cases) were compared with the outcomes of patients who fulfilled these critera for Fast Track, but instead were transported to the ED (controls). In all, 557 cases and 509 controls were identified. The latter spent a mean time of 237 min in the ED before admission. The 90-day mortality rate was 12.9% for cases and 14.7% for controls (n.s.). None of the secondary outcome events differed significantly between the groups: 28-day mortality rate; death rate during hospitalisation; proportion of pneumonias, falls or pressure ulcers; or health-related outcomes according to the EQ-5D-5L questionnaire. These findings indicates that the Fast Track to the stroke unit by an EMS is safe for selected stroke patients and could avoid non-valuable time in the ED.

show abstract

The health cost of reducing hospital bed capacity

Cited by 12 publications

References 37 publications

Cost Savings of Home Parenteral Nutrition Compared to Hospital Parenteral Nutrition: A Multicentre Prospective Analysis

Cost Savings of Home Parenteral Nutrition Compared to Hospital Parenteral Nutrition: A Multicentre Prospective Analysis

Predicting risk factors for pediatric mortality in clinical trial research: A retrospective, cross-sectional study using a Healthcare Cost and Utilization Project database

Fast track to stroke unit for patients not eligible for acute intervention, a case–control register study on 1066 patients

Contact Info

Product

Resources

About