Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model

Li, Wen; Shi, Junren; He, Simin; Luo, Xi; Zhong, Weijun; Yang, Fang

doi:10.1371/journal.pone.0248157

Cited by 9 publications

(6 citation statements)

References 42 publications

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“…It is also plausible that the suicide attempt group was more likely to have psychological symptoms compared with the no suicide attempt group, the presence of which is known to be associated with prolonged hospital stay [38,39]. Previous studies have reported that prolonging hospital LOS occupies beds and caregivers for a longer time, as well as increasing healthcare costs and economic burden [40,41]. The excess length of hospital stay is also known to be associated with increased complications, such as hospital-acquired infections [42,43].…”

Section: Discussionmentioning

confidence: 99%

Attempted Suicide Is Independently Associated with Increased In-Hospital Mortality and Hospital Length of Stay among Injured Patients at Community Tertiary Hospital in Japan: A Retrospective Study with Propensity Score Matching Analysis

Ono,

Ishida,

Tomita

et al. 2024

IJERPH

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Suicide is an increasingly important public healthcare concern worldwide. Studies examining the effect of attempted suicide on clinical outcomes among patients with trauma are scarce. We conducted a retrospective cohort study at a community emergency department in Japan. We included all severely injured patients with an Injury Severity Score > 15 from January 2002 to December 2021. The primary outcome measure was in-hospital mortality. The other outcome of interest was hospital length of stay. One-to-one propensity score matching was performed to compare these outcomes between suicide attempt and no suicide attempt groups. Of the 2714 eligible patients, 183 (6.7%) had trauma caused by a suicide attempt. In the propensity score-matched analysis with 139 pairs, the suicide attempt group showed a significant increase in-hospital mortality (20.9% vs. 37.4%; odds ratio 2.27; 95% confidence intervals 1.33–3.87) compared with the no suicide attempt group. Among survivors, the median hospital length of stay was significantly longer in the suicide attempt group than that in the no suicide attempt group (9 days vs. 12 days, p = 0.0076). Because of the unfavorable consequences and potential need for additional healthcare, increased attention should be paid to patients with trauma caused by a suicide attempt.

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Section: Discussionmentioning

confidence: 99%

Attempted Suicide Is Independently Associated with Increased In-Hospital Mortality and Hospital Length of Stay among Injured Patients at Community Tertiary Hospital in Japan: A Retrospective Study with Propensity Score Matching Analysis

Ono,

Ishida,

Tomita

et al. 2024

IJERPH

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“…If in-hospital psychiatric consultation becomes less available, it is likely to result in increased psychiatric hospital transfers and emergency ward LOS. Prolonging hospital LOS occupies beds and caregivers for a longer time, increases healthcare costs and economic burden, [35,36] and increases complications unrelated to admission diagnosis, such as hospital-acquired infections. [37,38] A shortage of psychiatric services is a ubiquitous problem in Japanese EDs, [7] despite the increasing number of ED presentations of patients with psychiatric illnesses.…”

Section: Discussionmentioning

confidence: 99%

Impact of closure of the in-house psychiatric care unit on prehospital and emergency ward length of stay and disposition locations in patients who attempted suicide

Ono

Kakamu

et al. 2021

Medicine

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Suicide is an increasingly serious public health care concern worldwide. The impact of decreased in-house psychiatric resources on emergency care for suicidal patients has not been thoroughly examined. We evaluated the effects of closing an in-hospital psychiatric ward on the prehospital and emergency ward length of stay (LOS) and disposition location in patients who attempted suicide. This was a retrospective before-and-after study at a community emergency department (ED) in Japan. On March 31, 2014, the hospital closed its 50 psychiatric ward beds and outpatient consultation days were decreased from 5 to 2 days per week. Electronic health record data of suicidal patients who were brought to the ED were collected for 5 years before the decrease in in-hospital psychiatric services (April 1, 2009–March 31, 2014) and 5 years after the decrease (April 1, 2014–March 31, 2019). One-to-one propensity score matching was performed to compare prehospital and emergency ward LOS, and discharge location between the 2 groups. Of the 1083 eligible patients, 449 (41.5%) were brought to the ED after the closure of the psychiatric ward. Patients with older age, burns, and higher comorbidity index values, and those requiring endotracheal intubation, surgery, and emergency ward admission, were more likely to receive ED care after the psychiatric ward closure. In the propensity matched analysis with 418 pairs, the after-closure group showed a significant increase in median prehospital LOS (44.0 minutes vs 51.0 minutes, P < .001) and emergency ward LOS (3.0 days vs 4.0 days, P = .014) compared with the before-closure group. The rate of direct home return was significantly lower in the after-closure group compared with the before-closure group (87.1% vs 81.6%, odds ratio: 0.66; 95% confidence interval: 0.45–0.96). The prehospital and emergency ward LOS for patients who attempted suicide in the study site increased significantly after a decrease in hospital-based mental health services. Conversely, there was significant reduction in direct home discharge after the decrease in in-house psychiatric care. These results have important implications for future policy to address the increasing care needs of patients who attempt suicide.

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“…( Hou et al, 2020 ; Hu, 2020 ; Mohapatra, Rajaram & Mallick, 2018 ), there were limited studies on the length of hospital stay and medical expenses on these patients. In general, the length of hospital stay can be influenced by many factors, such as baseline demographics, underlying comorbidities, disease complications, and medical expenses ( Chen et al, 2017 ; Liu et al, 2021 ). Prolonged length of hospital stay has been associated with high medical expenses, cognitive impairment, functional dependence, and high comorbidity ( Bo et al, 2016 ; Kamitani et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with length of hospital stay and medical expenses in pulmonary abscess patients: retrospective study

Zhu¹,

Yang²,

Lü³

2023

PeerJ

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Background Pulmonary abscess carries a high mortality and requires long-term managements. A better understanding of the risk factors associated with the prolonged hospital stay and high medical expenses in these patients can improve the management strategy in individual patient and optimize the overall healthcare resources. Methods We performed a retrospective study and reviewed the medical records on consecutive patients hospitalized at the Department of Respiratory Medicine of the General Hospital of Northern Theater Command, Shenyang, Liaoning, China, between January 1, 2015, and December 31, 2020. Demographics, comorbidity, clinical symptoms, laboratory tests, length of hospital stay, and medical expenses were recorded. Their relationships with the length of hospital stay and medical expenses in pulmonary abscess patients were analyzed. Results There were 190 patients with the pulmonary abscess and 12,189 patients without the pulmonary abscess. Compared with patients without the pulmonary abscess, patients with the pulmonary abscess had longer hospital stays (21.8 ± SD vs 12.8 ± SD, P < 0.01), In patients with the pulmonary abscess, the mean length of hospital stay was 5.3 days longer in male vs female patients (P = 0.025). Multivariate linear regression analyses showed that extrapulmonary disease and clinical symptoms were associated with the length of hospital stay and medical expenses, respectively. In addition, anemia was associated with both the length of hospital stay and medical expenses. Sex and hypoproteinemia were associated with the medical expenses. Conclusions The mean length of hospital stay was longer in patients with the pulmonary abscess than those without the pulmonary abscess. The length of hospital stay and medical expense were associated with sex, clinical symptoms, extrapulmonary disease, and abnormal laboratory tests in patients with the pulmonary abscess.

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Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model

Cited by 9 publications

References 42 publications

Attempted Suicide Is Independently Associated with Increased In-Hospital Mortality and Hospital Length of Stay among Injured Patients at Community Tertiary Hospital in Japan: A Retrospective Study with Propensity Score Matching Analysis

Attempted Suicide Is Independently Associated with Increased In-Hospital Mortality and Hospital Length of Stay among Injured Patients at Community Tertiary Hospital in Japan: A Retrospective Study with Propensity Score Matching Analysis

Impact of closure of the in-house psychiatric care unit on prehospital and emergency ward length of stay and disposition locations in patients who attempted suicide

Risk factors associated with length of hospital stay and medical expenses in pulmonary abscess patients: retrospective study

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