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Journal articles on the topic 'Inpatient hospital care'

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Published: 10 December 2022
Last updated: 28 January 2023

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1

Giardino, Angelo P., Tiffany Glasgow, Jill Sweney, and David Chaulk. "Pediatric inpatient hospital care." Hospital Practice 49, sup1 (October 13, 2021): 391–92. http://dx.doi.org/10.1080/21548331.2022.2050112.

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2

Mitchell, Colby L., Ernest R. Anderson, and Leeann Braun. "Billing for inpatient hospital care." American Journal of Health-System Pharmacy 60, suppl_6 (November 1, 2003): S8—S11. http://dx.doi.org/10.1093/ajhp/60.suppl_6.s8.

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3

Dorjdagva, Javkhlanbayar, Enkhjargal Batbaatar, Mikael Svensson, Bayarsaikhan Dorjsuren, Munkhsaikhan Togtmol, and Jussi Kauhanen. "Does social health insurance prevent financial hardship in Mongolia? Inpatient care: A case in point." PLOS ONE 16, no. 3 (March 31, 2021): e0248518. http://dx.doi.org/10.1371/journal.pone.0248518.

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Background Protecting people from financial hardship and impoverishment due to health care costs is one of the fundamental purposes of the Mongolian health system. However, the inefficient, oversized hospital sector is considered one of the main shortcomings of the system. The aim of this study is to contribute to policy discussions by estimating the extent of catastrophic health expenditure and impoverishment due to inpatient care at secondary-level and tertiary-level public hospitals and private hospitals. Methods Data were derived from a nationally representative survey, the Household Socio-Economic Survey 2012, conducted by the National Statistical Office of Mongolia. A total of 12,685 households were involved in the study. “Catastrophic health expenditure” is defined as out-of-pocket payments for inpatient care that exceed a threshold of 40% of households’ non-discretionary expenditure. The “impoverishment” effect of out-of-pocket payments for inpatient care was estimated as the difference between the poverty level before health care payments and the poverty level after these payments. Results At the threshold of 40% of capacity to pay, 0.31%, 0.07%, and 0.02% of Mongolian households suffered financially as a result of their member(s) staying in tertiary-level and secondary-level public hospitals and private hospitals respectively. About 0.13% of the total Mongolian population was impoverished owing to out-of-pocket payments for inpatient care at tertiary-level hospitals. Out-of-pocket payments for inpatient care at secondary-level hospitals and private hospitals were responsible for 0.10% and 0.09% respectively of the total population being pushed into poverty. Conclusions Although most inpatient care at public hospitals is covered by the social health insurance benefit package, patients who utilized inpatient care at tertiary-level public hospitals were more likely to push their households into financial hardship and poverty than the inpatients at private hospitals. Improving the hospital sector’s efficiency and financial protection for inpatients would be a crucial means of attaining universal health coverage in Mongolia.
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Wang, Wenhua, Ekaterina Loban, and Emilie Dionne. "Public Hospitals in China: Is There a Variation in Patient Experience with Inpatient Care." International Journal of Environmental Research and Public Health 16, no. 2 (January 11, 2019): 193. http://dx.doi.org/10.3390/ijerph16020193.

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In China, public hospitals are the main provider of inpatient service. The Chinese public hospital reform has recently shifted towards health care organizations and delivery to improve health care quality. This study analyzes the variation of one of the dimensions of health care quality, patient-centeredness, among inpatients with different socioeconomic status and geographical residency in China. 1471 respondents who received inpatient care in public hospitals were included in our analysis. Patient-centeredness performance was assessed on the dimensions of Communication, Autonomy, Dignity, and Confidentiality. Variations of inpatient experience were estimated using binary logistic regression models according to: residency, region, age, gender, education, income quintile, self-rated health, and number of hospital admissions. Our results indicate that older patients, and patients living in rural areas and Eastern China are more likely to report positive experience of their public hospital stay according to the care aspects of Dignity, Communication, Confidentiality and Autonomy. However, there remains a gap between China and other countries in relation to inpatient experience. Noticeable disparities in inpatient experience also persist between different geographical regions in China. These variations of patient experience pose a challenge that China’s health policy makers would need to consider in their future reform efforts.
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PS, Ramkumar, Arjun J. S, Ritudisha Biswas, and Sandeep Patil H G. "Remote Attention System for Inpatient Care." International Journal of Emerging Research in Management and Technology 6, no. 7 (June 29, 2018): 278. http://dx.doi.org/10.23956/ijermt.v6i7.225.

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ICU management has been daunting task for the hospital administration, doctors are expected to rush back to the hospital on call even after returning home, even if it is middle of night, to inspect critical developments of patient’s condition and decide further action immediately. The problem multiplies when doctors are consultants to multiple hospitals. . Hospitals face scarcity of experts who can engage full time, especially when physical presence is required on demand. This paper illustrates an initiative that is driven by collaborating Hospitals as care provider partners and Applied cognition Systems as technology partner to enable virtual presence of remote specialists in collaboration with local doctors as needed in emergency response, remote monitoring and real time consultation for management of patients admitted in wards and ICUs of hospitals.
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Wahyuningrum, Sri Hartuti, and Mustika K. Wardhani. "EFFICIENCY OF INPATIENT LAYOUT IN PRIVATE HOSPITAL (Case Study: Bhakti Asih Hospital, Brebes Central Java)." MODUL 20, no. 01 (March 29, 2020): 1–9. http://dx.doi.org/10.14710/mdl.20.01.2020.1-9.

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In the context of hospital building, inpatient care has large portion in comparasion of the other facility areas within hospitals related to efficiency, such as outpatient services, emergency room, diagnostic and especially inpatient function group services. Even though inpatient care group do not have specific requirements for detailed design and building equipment, it requires efficiency considerations related to correlation with room layout. It is expected that by considering the level of efficiency of service to patients, design can fulfill technical requirements of health and medical aspects. Regarding designs for district-level private hospitals, demand optimization of placement and layout of inpatient care became main topic in this research. This is related to the value of investment in building area development and types of services provided according to inpatient services class. The method used is comparative study of two (2) private hospital design to find the mind factors that most influence of optimization of inpatient layout. The results of study can be used as a guide in architectural design process for designing hospital buildings especially related to design efficiency of inpatient layout so that the building can function sustainability because of optimal service.
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7

Trivedi, Rohit, and Khyati Jagani. "Perceived service quality, repeat use of healthcare services and inpatient satisfaction in emerging economy." International Journal of Pharmaceutical and Healthcare Marketing 12, no. 3 (September 3, 2018): 288–306. http://dx.doi.org/10.1108/ijphm-11-2017-0065.

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Purpose The purpose of this study is to understand that how different demographic variables and repeated availing of service from the same doctor or same hospital shape the overall perception of health-care service quality and satisfaction among inpatients admitted in private hospitals in an emerging economy. Design/methodology/approach A self-administered, cross-sectional survey of inpatients using a questionnaire was translated into Hindi and Gujarati. The data were collected from 702 inpatients from 18 private clinics located in three selected cities from Western India. Findings The results indicate that experience with hospital administration, doctors, nursing staff, physical environment, hospital pharmacy and physical environment is significant predictor of inpatient satisfaction. Physical environment was found to be significantly associated with satisfaction only among female inpatient. It was also found that repeat availing of services either from the same hospital or doctor does not increase patient satisfaction. The feasibility, reliability and validity of the instrument that measures major technical and nontechnical dimensions of quality of health-care services were established in the context of a developing country. Originality/value The study makes important contribution by empirically investigating the inpatient assessment of health-care service quality based upon their demographic information and repeated availing of services to understand how repeat visit shapes the service quality perception.
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8

J., Sheela, and Malarvizhi S. "THE EFFECT OF STRUCTURED NURSING ROUNDS ON THE LEVEL NURSING CARE SATISFACTION OF PATIENT IN A SELECTED TERTIARY CARE HOSPITAL, PUDUCHERRY." International Journal of Advanced Research 10, no. 09 (September 30, 2022): 452–66. http://dx.doi.org/10.21474/ijar01/15377.

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This exploratory study investigated the relationship among staff nurses assessment of organizational culture, job satisfaction, inpatient satisfaction with information about home care and follow-up, and general inpatient satisfaction with nursing care. A conceptual path model was tested using a secondary data analysis research design. Staff nurses and inpatients were sampled from inpatient units. The unit of analysis was patient care units. Pearson correlation and regression analyses were used. We found that strength of organizational culture predicted job satisfaction well and positively job satisfaction predicted inpatient satisfaction significantly and positively and inpatient satisfaction predicted general inpatient satisfaction well and positively. Methodological challenges of this study are discussed.
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9

Barbaro, Ryan P., Philip S. Boonstra, Frank W. Moler, Matthew M. Davis, and Lisa A. Prosser. "Hospital-level variation in inpatient cost among children receiving extracorporeal membrane oxygenation." Perfusion 32, no. 7 (March 24, 2017): 538–46. http://dx.doi.org/10.1177/0267659117702709.

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Objective: Pediatric extracorporeal membrane oxygenation (ECMO) varies in the way care is provided from hospital to hospital. This variability in hospital ECMO care can be represented by the variation in ECMO costs. We hypothesized that hospitals will demonstrate large variations in case-mix-adjusted ECMO inpatient costs for children requiring ECMO and higher volume hospitals will have lower associated costs. Methods: We retrospectively analyzed the inpatient cost of children receiving ECMO in 2006, 2009 and 2012, using the Healthcare Cost and Utilization Project Kids’ Inpatient Database. We used a hierarchical linear regression model and the intraclass correlation coefficient to quantify how much of the difference in ECMO inpatient costs was associated with the hospital where a child received care. To do this, we adjusted for patient factors, hospital factors and potentially modifiable factors such as complications, procedures and length of stay. Results: The median inflation-adjusted inpatient costs for children requiring ECMO were $183,000, $240,000 and $241,000 in years 2006, 2009 and 2012, respectively. The largest median cost for ECMO cases in a given hospital in a given year ($690,000) was more than 11 times that of the smallest median cost ($60,000). After case-mix adjustment, 27% of the variation in inpatient costs was associated with the hospital where ECMO care was provided. Average hospital costs were not associated with hospital ECMO volume. Conclusions: The large variation in ECMO inpatient costs between hospitals suggests great variation in care between hospitals, which is important because hospitals have a co-existing variation in ECMO survival rates.
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10

Black, Beverly L. "Competitive alternatives to hospital inpatient care." American Journal of Health-System Pharmacy 42, no. 3 (March 1, 1985): 545–53. http://dx.doi.org/10.1093/ajhp/42.3.545.

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11

Aiken, Linda H., Douglas M. Sloane, Jane Ball, Luk Bruyneel, Anne Marie Rafferty, and Peter Griffiths. "Patient satisfaction with hospital care and nurses in England: an observational study." BMJ Open 8, no. 1 (December 5, 2017): e019189. http://dx.doi.org/10.1136/bmjopen-2017-019189.

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ObjectivesTo inform healthcare workforce policy decisions by showing how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels and hospital work environments.DesignCross-sectional surveys of 66 348 hospital patients and 2963 inpatient nurses.SettingPatients surveyed were discharged in 2010 from 161 National Health Service (NHS) trusts in England. Inpatient nurses were surveyed in 2010 in a sample of 46 hospitals in 31 of the same 161 trusts.ParticipantsThe 2010 NHS Survey of Inpatients obtained information from 50% of all patients discharged between June and August. The 2010 RN4CAST England Nurse Survey gathered information from inpatient medical and surgical nurses.Main outcome measuresPatient ratings of their hospital care, their confidence in nurses and doctors and other indicators of their satisfaction. Missed nursing care was treated as both an outcome measure and explanatory factor.ResultsPatients’ perceptions of care are significantly eroded by lack of confidence in either nurses or doctors, and by increases in missed nursing care. The average number of types of missed care was negatively related to six of the eight outcomes—ORs ranged from 0.78 (95% CI 0.68 to 0.90) for excellent care ratings to 0.86 (95% CI 0.77 to 0.95) for medications completely explained—positively associated with higher patient-to-nurse ratios (b=0.15, 95% CI 0.10 to 0.19), and negatively associated with better work environments (b=−0.26, 95% CI −0.48 to −0.04).ConclusionsPatients’ perceptions of hospital care are strongly associated with missed nursing care, which in turn is related to poor professional nurse (RN) staffing and poor hospital work environments. Improving RN staffing in NHS hospitals holds promise for enhancing patient satisfaction.
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12

Laktionova, L. V. "Modern development strategies in hospital care." Journal of Clinical Practice 2, no. 4 (November 15, 2011): 73–80. http://dx.doi.org/10.17816/clinpract83668.

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The article presents the results of modern development strategies of inpatient care in the modernization of the federal multidisciplinary clinic. The problems of health care development in Russian Federation and the possible ways of solution on the local level are discussed to improve the quality and accessibility of medical aid.Keywords: modernization of health care, inpatient care
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13

Mant, Madeleine. "Children in the London: Inpatient Care in a Voluntary General Hospital." Medical History 62, no. 3 (June 11, 2018): 295–313. http://dx.doi.org/10.1017/mdh.2018.24.

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The presence of children in English voluntary hospitals during the eighteenth century has only recently come under academic scrutiny. This research examines the surviving admission records of the London Hospital, which consistently record inpatient ages, to illuminate the hospital stays of infant and child patients and examine the morbidity of children during the long eighteenth century. Traumatic cases were the most common category of admission. The proportion of trauma cases admitted to the London Hospital was higher than in provincial English child patient cohorts, potentially reflecting the differential risks faced by rural and urban children. In most cases of traumatic injury the inpatients stayed in hospital long enough for significant fracture healing to have occurred. Understanding the conditions surrounding children’s admission to hospital, their length of stay, the result of their stay, and which medical issues drove their parents or guardians to seek medical attention for them are critical to illuminating the morbidity of children during the long eighteenth century.
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14

Uto, Y., F. Muranaga, I. Kumamoto, and C. Matsumoto. "DPC in Acute-phase Inpatient Hospital Care." Methods of Information in Medicine 52, no. 06 (2013): 522–35. http://dx.doi.org/10.3414/me12-01-0090.

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SummaryObjective: The purpose of this study was to improve accessibility to nursing care by clari -fying the relationship between patient characteristics and the amount of nursing care for the Diagnosis Procedure Combination system (DPC).Method: The subjects included 528 lung cancer patients; 170 gastric cancer patients; and 91 colon cancer patients, who were hospitalized from July 1, 2008, to March 31, 2010, at a university hospital. The patients were categorized into groups according to factors that could affect the amount of nursing care. Next, the relationship between the patient characteristics and the amount of nursing care was analyzed. Then the results from this study were used to classify patient characteristics according to the patient type and the amount nursing care required.Results: The patient characteristics, which affected the amount of nursing care, varied according to each DPC code. The major factors affecting the amount of nursing care were whether the patient had received a surgical (under general anesthetics) treatment or a non-surgical treatment and the level of activities of daily living (ADL) of the hospitalized patients. For those who had received a surgical operation for colon cancer, the patient’s age also affected the amount of nursing care.Conclusions: The findings show that the method for the visualization of the amount of nursing care based on the classification of patient characteristics can be implemented into the electronic health record system. This method can then be used as a management tool to assure appropriate distribution of nursing resources.
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15

Christman, Luther P. "An Introduction to Hospital and Inpatient Care." Nursing Administration Quarterly 28, no. 1 (January 2004): 75. http://dx.doi.org/10.1097/00006216-200401000-00019.

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16

Firshein, Janet. "Hospital doctors wanted for US inpatient care." Lancet 348, no. 9029 (September 1996): 747. http://dx.doi.org/10.1016/s0140-6736(05)65627-9.

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17

Henderson, J., M. Goldacre, and D. Yeates. "Use of hospital inpatient care in adolescence." Archives of Disease in Childhood 69, no. 5 (November 1, 1993): 559–63. http://dx.doi.org/10.1136/adc.69.5.559.

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18

Walkup, James. "Family involvement in general hospital inpatient care." New Directions for Mental Health Services 21, no. 73 (1997): 51–64. http://dx.doi.org/10.1002/yd.2330217307.

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Walkup, James. "Family involvement in general hospital inpatient care." New Directions for Mental Health Services 1997, no. 73 (1997): 51–64. http://dx.doi.org/10.1002/yd.23319977307.

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20

Mardiani, Mardiani. "PEMENUHAN KEBUTUHAN SPIRITUAL CARE PASIEN RAWAT INAP." JURNAL MEDIA KESEHATAN 10, no. 1 (November 15, 2018): 001–6. http://dx.doi.org/10.33088/jmk.v10i1.316.

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Nurses who have the ability to identify and understand the spiritual aspects of thepatient, will be able to carry out spiritual fulfillment and knowing how spiritual beliefs can affectthe life of every individual. The purpose of this research is the perception of nurses correlationwith the fulfillment of the spiritual care of patients in inpatient hospitals Dr.M. YunusBengkulu. The type of this research is analityc with cross sectional design. The Researchsample is nurses inpatient ward of RSUD Dr. M. Yunus Bengkulu who numbered 83 nursestaken with total sampling technique. Research done at eight wards hospitals Dr. M YunusBengkulu for two months. Collecting data using a questionnaire. Quantitative data analysis isunivariate and bivariate with uji chi-square at α 5%. The results showed that there was a significantrelationship between the perception of nurses and spiritual fulfillment of inpatientcare in hospitals Dr.M.Yunus Bengkulu (p : 0.022) with OR 3.107 (95% CI : 1.265 to 7.630),which means nurses have perceptionless chance three times to apply the spiritual care that isless favorable than that good perception. To the Hospital Dr. M. Yunus Bengkulu expectedfor the provision of facilities and additional skills for nurses in the inpatient room about theimportance of spiritual fulfillment as well as the necessary care program to improve the perceptionof nursing care, especially for spiritual fulfillment inpatients.
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Rooke, Amanda, and Sarah Morgan. "An evaluation of a psychiatric and medical shared care service model offered at a general hospital site." FPOP Bulletin: Psychology of Older People 1, no. 110 (April 2010): 29–36. http://dx.doi.org/10.53841/bpsfpop.2010.1.110.29.

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This article aims to describe an evaluation of a ‘shared care’ service model combining psychiatric and medical care to older adult inpatients residing at a general hospital medical ward. The first ward of its kind in the UK, it was set up in April 2008 with the aim of providing good quality care for older adults experiencing a combination of mental and physical health problems. The project evaluated the utility of the care model using group comparison of shared care and non-shared care inpatient case notes on a number of variables including the location the patient was discharged to, number of days spent as an inpatient at hospital, and number of transfers to alternative wards in hospital.Results revealed that more ‘shared care’ patients were discharged home as opposed to care homes, they also spent significantly less time in hospital and experienced less transfers to other wards whilst residing in hospital.
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Cairns, Shona, Jacqui Reilly, Sally Stewart, Debbie Tolson, Jon Godwin, and Paul Knight. "The Prevalence of Health Care–Associated Infection in Older People in Acute Care Hospitals." Infection Control & Hospital Epidemiology 32, no. 8 (August 2011): 763–67. http://dx.doi.org/10.1086/660871.

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Objective.To determine the prevalence of health care-associated infection (HAI) in older people in acute care hospitals, detailing the specific types of HAI and specialties in which these are most prevalent.Design.Secondary analysis of the Scottish National Healthcare Associated Infection Prevalence Survey data set.Patients and Setting.All inpatients in acute care (n = 11,090) in all acute care hospitals in Scotland (n = 45).Results.The study found a linear relationship between prevalence of HAI and increasing age (P<.0001) in hospital inpatients in Scotland. Urinary tract infections and gastrointestinal infections represented the largest burden of HAI in the 75–84- and over-85-year age groups, and surgical-site infections represented the largest burden in inpatients under 75 years of age. The prevalence of urinary catheterization was higher in each of the over-65 age groups (P<.0001). Importantly, this study reveals that a high prevalence of HAI in inpatients over the age of 65 years is found across a range of specialties within acute hospital care. An increased prevalence of HAI was observed in medical, orthopedic, and surgical specialties.Conclusions.HAI is an important outcome indicator of acute inpatient hospital care, and our analysis demonstrates that HAI prevalence increases linearly with increasing age (P<.0001). Focusing interventions on preventing urinary tract infection and gastrointestinal infections would have the biggest public health benefit. To ensure patient safety, the importance of age as a risk factor for HAI cannot be overemphasized to those working in all areas of acute care.
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Goss, Adeline L., and Claire J. Creutzfeldt. "Neuropalliative Care in the Inpatient Setting." Seminars in Neurology 41, no. 05 (October 2021): 619–30. http://dx.doi.org/10.1055/s-0041-1731071.

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AbstractThe palliative care needs of inpatients with neurologic illness are varied, depending on diagnosis, acuity of illness, available treatment options, prognosis, and goals of care. Inpatient neurologists ought to be proficient at providing primary palliative care and effective at determining when palliative care consultants are needed. In the acute setting, palliative care should be integrated with lifesaving treatments using a framework of determining goals of care, thoughtfully prognosticating, and engaging in shared decision-making. This framework remains important when aggressive treatments are not desired or not available, or when patients are admitted to the hospital for conditions related to advanced stages of chronic neurologic disease. Because prognostic uncertainty characterizes much of neurology, inpatient neurologists must develop communication strategies that account for uncertainty while supporting shared decision-making and allowing patients and families to preserve hope. In this article, we illustrate the approach to palliative care in inpatient neurology.
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Olson, Michael T., Shaimaa Elnahas, Sreeja Biswas Roy, Paul Kang, Tracy Knight, Katherine E. Grief, Brandi Krushelniski, Rajat Walia, Ross M. Bremner, and Michael A. Smith. "Inpatient Lung Transplant Evaluation Is Associated With Increased Risk of Morbidity, Mortality, and Cost of Care After Transplant." Progress in Transplantation 31, no. 3 (July 19, 2021): 219–27. http://dx.doi.org/10.1177/15269248211024612.

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Lung transplantation is an important option for patients with end-stage lung disease. Many of these patients deteriorate rapidly and require inpatient care at the time of the transplant evaluation. Research Question: How does the setting of lung transplant evaluation relate to perioperative outcomes, short-term postoperative outcomes, and healthcare costs accrued after transplant? Design: We reviewed the records of patients who underwent primary, bilateral lung transplantation at our center between January 1, 2014 and May 31, 2016. Patient evaluation setting was categorized as inpatient, outpatient, or combined. Demographics, clinical characteristics, and cost of care were assessed. Results: The study included 207 patients: 40 (19.3%) evaluated as inpatients, 146 (70.5%) as outpatients, and 21 (10.1%) as combined. Inpatients had the highest mean lung allocation scores (71.2 vs 49.7 [combined] and 40.8 [outpatient]; P < 0.001), lowest functional status at listing ( P < 0.001), highest number of blood products used during surgery ( P < 0.001), highest incidence of re-exploration for bleeding ( P = 0.006), and longest posttransplant hospital stays (median, 35 vs 15 days [combined] and 12 days [outpatient]; P < 0.001). One-year survival trended lower for inpatients (log-rank, P = 0.056). Inpatient evaluations had the highest total, variable, and fixed costs of posttransplant care ( P < 0.001). Conclusion: Inpatient lung transplant evaluation was associated with longer hospital stays, higher perioperative morbidity, and lower 1-year survival. Partial or complete inpatient evaluation was associated with a higher cost of care posttransplant.
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Hensher, Martin, Naomi Fulop, Sonja Hood, and Sarah Ujah. "Does Hospital-at-Home Make Economic Sense? Early Discharge Versus Standard Care for Orthopaedic Patients." Journal of the Royal Society of Medicine 89, no. 10 (October 1996): 548–51. http://dx.doi.org/10.1177/014107689608901003.

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Hospital-at-home has been promoted as a potentially effective means of replacing costly inpatient care with cheaper domiciliary care. We studied three hospital-at-home schemes in West London providing intensive home care for early discharge orthopaedic patients, comparing their costs with those of standard inpatient care. Although costs per day of hospital-at-home care were lower than those of inpatient care, the schemes appeared to increase the total duration of orthopaedic episodes, so that the costs of standard care, per episode, were lower than those of hospital-at-home. While hospital-at-home may offer considerable future potential, substitution of home care for inpatient care will not necessarily save resources.
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Neale, Graham, and Sisse Olsen. "Rise and demise of the hospital: Managing hospital inpatient care." BMJ 332, no. 7532 (January 5, 2006): 52.5. http://dx.doi.org/10.1136/bmj.332.7532.52-d.

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27

Melzer, Sanford M., David C. Grossman, and Frederick P. Rivara. "Physician Experience With Pediatric Inpatient Care in Washington State." Pediatrics 97, no. 1 (January 1, 1996): 65–70. http://dx.doi.org/10.1542/peds.97.1.65.

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Objective. To determine the frequency with which pediatricians and family physicians in Washington State serve as attending physicians for pediatric inpatients. Design. Retrospective review of statewide hospital discharge data. Subjects. Attending physicians for all patients younger than 18 years of age with nonsurgical diagnoses discharged from civilian hospitals in Washington State during 1989 and 1990. Results. Using medical rosters, the self-identified specialty of the attending physician was determined for 93% (n = 181 581) of discharges. Pediatricians and family physicians were listed as attending for 61% and 28%, respectively, of all eligible patients. Statewide, 97% (n = 555) of all pediatricians and 86% (n = 939) of all family physicians served as attending physicians for at least one inpatient, including healthy newborns, during the 2-year study period. The median annual number of discharges per physician was 78 for pediatricians and 14.5 for family physicians. Excluding healthy newborns, the median annual number of discharges was 25 for pediatricians and 3 for family physicians. Five percent of the physician attending group provided inpatient care for 50% of all children hospitalized with diagnoses other than healthy newborn; 50% of attending physicians cared for 95% of the patients. In rural hospitals, where family physicians served as attending physicians for 44% of pediatric inpatients, children were 3.3 times more likely to receive their care from family physicians than those hospitalized in urban centers. Conclusions. Most pediatricians and family physicians serve as inpatient attending physicians for hospitalized children only infrequently. These findings question whether the emphasis on inpatient care in many pediatric and family medicine training programs remains an appropriate goal.
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Priem, Jennifer, Lisa Krinner, Stephanie Murphy, Sveta Monahan, and Colleen Hole. "Care innovations and health disparities: An exploration of COVID-19 outcomes in inpatient and hospital-at-home care settings." Antimicrobial Stewardship & Healthcare Epidemiology 2, S1 (May 16, 2022): s43. http://dx.doi.org/10.1017/ash.2022.138.

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Background: Hospital at home (HaH) programs have been a critical resource for providing inpatient care to acutely ill patients throughout the COVID-19 pandemic. Given that this innovative care delivery model relies on technology and environmental concerns, questions have been raised about the effectiveness of HaH for vulnerable groups. However, evidence is extremely limited regarding equity issues in the HaH context. Thus, we explored COVID-19 outcomes within vulnerable groups. Methods: We conducted a matched, retrospective study of 116 acutely ill patients with COVID-19, aged ≥18 years, who presented to an AH emergency department (ED) and were admitted for inpatient care. Treatment patients were admitted to AH HaH between July 15 and September 31, 2020, and control patients were hospitalized between May 8 and June 25, 2020. Patients were matched based on oxygen requirement and DS CRB-65 (DEFINE) score. Race or ethnicity and area deprivation index (ADI) were chosen as predictors of health disparities. The ADI incorporates 17 indicators of poverty, educational attainment, and housing quality at the census tract level. Outcomes included 30-day (from discharge) severe illness or death composite, IP readmission, and ED visit. Results: The frequency of 30-day severe illness or death and ED visits were equivalent between the groups (n = 11; ED n = 5); the proportion of severe illness was higher for White patients in AH-HaH (n = 9 vs n = 5), and for Hispanic patients treated in the hospital (n = 5 vs n = 0; Fig. 1). There were no 30-day inpatient readmissions in the AH-HaH group, but 8 readmissions occurred with inpatients. The distribution of severe illness among the ADI quintiles varied. For traditional inpatients, disease progression was limited to ADI Q3–5 (Q3 = 3, Q4 = 6, Q5 = 2); for AH-HaH patients, disease progression was not influenced by ADI. The effect of ADI on 30-day ED readmission was nonsignificant. Conclusions: Although exploratory in nature, the results suggest that HaH may help combat sources of health disparities that have dominated the pandemic. Although inpatient care resulted in inpatient readmissions, mainly among Black and Hispanic patients, AH-HaH stays were not associated with any inpatient readmissions. The equivalent distribution among ADI quintiles of patients who became severely ill within 30 days of their AH-HaH stay suggests that HaH may be able to leverage innovation to reach vulnerable populations and reduce the impact of factors that contribute to inequity.Funding: NoneDisclosures: None
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Jacobs, Philip, Edward M. Hall, Judith R. Lave, and Murray Glendining. "Alberta's Acute Care Funding Project." Healthcare Management Forum 5, no. 3 (October 1992): 4–11. http://dx.doi.org/10.1016/s0840-4704(10)61210-0.

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Alberta initiated the Acute Care Funding Project (ACFP) in 1988, a new hospital funding system that institutes case mix budgeting adjustments to the global budget so that hospitals can be treated more equitably. The initiative is a significant departure in principle from the former method of funding. The ACFP is summarized and critiqued, and focuses on the inpatient side of the picture. The various elements of the project are discussed, such as the hospital performance index, the hospital performance measure, the Refined Diagnostic Related Group, case weights, typical and outlier cases, and the costing mechanisms. Since its implementation, the ACFP has undergone substantial changes; these are discussed, as well as some of the problems that still need to be addressed. Overall, the system offers incentives to reduce length of stay and to increase the efficiency with which inpatient care is provided.
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Lee, David C., Silas W. Smith, Christopher M. McStay, Ian Portelli, Lewis R. Goldfrank, Gregg Husk, and Nirav R. Shah. "Rebuilding Emergency Care After Hurricane Sandy." Disaster Medicine and Public Health Preparedness 8, no. 2 (April 2014): 119–22. http://dx.doi.org/10.1017/dmp.2014.19.

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AbstractA freestanding, 911-receiving emergency department was implemented at Bellevue Hospital Center during the recovery efforts after Hurricane Sandy to compensate for the increased volume experienced at nearby hospitals. Because inpatient services at several hospitals remained closed for months, emergency volume increased significantly. Thus, in collaboration with the New York State Department of Health and other partners, the Health and Hospitals Corporation and Bellevue Hospital Center opened a freestanding emergency department without on-site inpatient care. The successful operation of this facility hinged on key partnerships with emergency medical services and nearby hospitals. Also essential was the establishment of an emergency critical care ward and a system to monitor emergency department utilization at affected hospitals. The results of this experience, we believe, can provide a model for future efforts to rebuild emergency care capacity after a natural disaster such as Hurricane Sandy. (Disaster Med Public Health Preparedness. 2014;0:1-4)
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Cutler, Eli, Zeynal Karaca, Rachel Henke, Michael Head, and Herbert S. Wong. "The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 2018): 004695801880009. http://dx.doi.org/10.1177/0046958018800092.

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Studies have linked Accountable Care Organizations (ACOs) to improved primary care, but there is little research on how ACOs affect care in other settings. We examined whether Medicare ACOs have improved hospital quality of care, specifically focusing on preventable inpatient mortality. We used 2008-2014 Healthcare Cost and Utilization Project hospital discharge data from 34 states’ Medicare ACO and non-ACO hospitals in conjunction with data from the American Hospital Association Annual Survey and the Survey of Care Systems and Payment. We estimated discharge-level logistic regression models that measured the relationship between ACO affiliation and mortality following admissions for acute myocardial infarction, abdominal aortic aneurysm (AAA) repair, coronary artery bypass grafting, and pneumonia, controlling for patient demographic mix, hospital, and year. Our results suggest that, on average, Medicare ACO hospitals are not associated with improved mortality rates for the studied IQI conditions. Stakeholders may potentially consider providing ACOs with incentives or designing new programs for ACOs to target inpatient mortality reductions.
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Garg, N., G. Husk, T. Nguyen, A. Onyile, S. Echezona, G. Kuperman, and J. S. Shapiro. "Hospital Closure and Insights into Patient Dispersion." Applied Clinical Informatics 06, no. 01 (2015): 185–99. http://dx.doi.org/10.4338/aci-2014-10-ra-0090.

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SummaryBackground: Hospital closures are becoming increasingly common in the United States. Patients who received care at the closing hospitals must travel to different, often farther hospitals for care, and nearby remaining hospitals may have difficulty coping with a sudden influx of patients.Objectives: Our objectives are to analyze the dispersion patterns of patients from a closing hospital and to correlate that with distance from the closing hospital for three specific visit types: emergency, inpatient, and ambulatory.Methods: In this study, we used data from a health information exchange to track patients from Saint Vincent’s Medical Center, a hospital in New York City that closed in 2010, to determine where they received emergency, inpatient, and ambulatory care following the closure.Results: We found that patients went to the next nearest hospital for their emergency and inpatient care, but ambulatory encounters did not correlate with distance.Discussion: It is likely that patients followed their ambulatory providers as they transitioned to another hospital system. Additional work should be done to determine predictors of impact on nearby hospitals when another hospital in the community closes in order to better prepare for patient dispersion.Citation: Garg N, Husk G, Nguyen T, Onyile A, Echezona S, Kuperman G, Shapiro JS. Hospital closure and insights into patient dispersion: the closure of Saint Vincent’s Catholic Medical Center in New York City. Appl Clin Inf 2015; 6: 185–199http://dx.doi.org/10.4338/ACI-2014-10-RA-0090
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Mielonen, Marja-Leena, Arto Ohinmaa, Juha Moring, and Matti Isohanni. "Psychiatric inpatient care planning via telemedicine." Journal of Telemedicine and Telecare 6, no. 3 (June 1, 2000): 152–57. http://dx.doi.org/10.1258/1357633001935248.

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We assessed the costs of psychiatric inpatient care-planning consultations to remote areas using videoconferencing, instead of the conventional face-to-face consultations at a hospital. The data were collected from all wards at the department of psychiatry of Oulu University Hospital over 11 months. A total of 14 videoconferences were conducted with two primary-care centres located 220 km and 160 km from Oulu. During the same period, 20 conventional consultations at the Oulu University Hospital were also assessed. A questionnaire was completed by a total of 124 patients, relatives and health-care personnel; the response rate was about 90%. Of the respondents, 90% were satisfied with the quality of communication afforded by videoconferencing. At a workload of 20 patients per year, the cost of the videoconferences was FM2510 per patient; the cost of the conventional alternative was FM4750 per patient. At 50 care consultations per year, a remote municipality would save about FM117,000.
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Assareh, Hassan, Joanne M. Stubbs, Lieu T. T. Trinh, Sally Greenaway, Meera Agar, and Helen M. Achat. "Variations in hospital inpatient palliative care service use: a retrospective cohort study." BMJ Supportive & Palliative Care 10, no. 3 (November 8, 2018): e27-e27. http://dx.doi.org/10.1136/bmjspcare-2018-001578.

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ObjectiveUse of palliative care in hospitals for people at end of life varies. We examined rate and time of in-hospital palliative care use and associated interhospital variations.MethodsWe used admissions from all hospitals in New South Wales, Australia, within a 12-month period, for a cohort of adults who died in 73 public acute care hospitals between July 2010 and June 2014. Receiving palliative care and its timing were based on recorded use.ResultsAmong 90 696 adults who died, 27% received palliative care, and the care was initiated 7.6 days (mean; SD: 3.3 days) before death. Over the 5-year period, the palliative care rate rose by 58%, varying extent across chronic conditions. The duration of palliative care before death declined by 7%. Patient (demographics, morbidities and service use) and hospital factors (size, location and availability of palliative care unit) explained half of the interhospital variation in outcomes: adjusted IQR in rate and duration of palliative care among hospitals were 23%–39% and 5.2–8.7 days, respectively. Hospitals with higher rates often initiated palliative care earlier (correlation: 0.39; p<0.01).ConclusionDespite an increase over time in the palliative care rate, its initiation was late and of brief duration. Palliative care use was associated with patient and hospital characteristics; however, half of the between hospital variation remained unexplained. The observed suboptimal practices and variability indicate the need for expanded and standardised use of palliative care supported by assessment tools, service enhancement and protocols.
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Montalbano, Amanda, Ricardo A. Quinonex, Matt Hall, Rustin Morse, Stacey L. Ishman, James W. Antoon, Jessica Gold, et al. "Achievable Benchmarks of Care for Pediatric Readmissions." Journal of Hospital Medicine 14, no. 9 (May 10, 2019): 534–50. http://dx.doi.org/10.12788/jhm.3201.

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BACKGROUND: Most inpatient care for children occurs outside tertiary children’s hospitals, yet these facilities often dictate quality metrics. Our objective was to calculate the mean readmission rates and the Achievable Benchmarks of Care (ABCs) for pediatric diagnoses by different hospital types: metropolitan teaching, metropolitan nonteaching, and nonmetropolitan hospitals. METHODS: We used a cross-sectional retrospective study of 30-day, all-cause, same-hospital readmission of patients less than 18 years old using the 2014 Healthcare Utilization Project National Readmission Database. For each hospital type, we calculated the mean readmission rates and corresponding ABCs for the 17 most common readmission diagnoses. We define outlier as any hospital whose readmission rate fell outside the 95% CI for an ABC within their hospital type. RESULTS: We analyzed 690,949 discharges at 525 metropolitan teaching hospitals (550,039 discharges), 552 metropolitan nonteaching hospitals (97,207 discharges), and 587 nonmetropolitan hospitals (43,703 discharges). Variation in readmission rates existed among hospital types; however, sickle cell disease (SCD) had the highest readmission rate and ABC across all hospital types: metropolitan teaching hospitals 15.7% (ABC 7.0%), metropolitan nonteaching 14.7% (ABC 2.6%), and nonmetropolitan 12.8% (ABC not calculated). For diagnoses in which ABCs were available, outliers were prominent in bipolar disorders, major depressive disorders, and SCD. CONCLUSIONS: ABCs based on hospital type may serve as a better metric to explain case-mix variation among different hospital types in pediatric inpatient care. The mean rates and ABCs for SCD and mental health disorders were much higher and with more outlier hospitals, which indicate high-value targets for quality improvement.
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Schaum, Kathleen D. "New Acute Care Inpatient Hospital Payment System Affects Wound Care." Advances in Skin & Wound Care 21, no. 10 (October 2008): 458–60. http://dx.doi.org/10.1097/01.asw.0000323569.90379.7b.

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Lu, Bei, Hong Mi, Gaoyun Yan, Jonathan K. H. Lim, and Guanggang Feng. "Substitutional effect of long-term care to hospital inpatient care?" China Economic Review 62 (August 2020): 101466. http://dx.doi.org/10.1016/j.chieco.2020.101466.

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Livorsi, Daniel J., Jade Feller, Brian Lund, Bruce Alexander, Rajeshwari Nair, Brice Beck, Michihiko Goto, Brett Heintz, and Eli N. Perencevich. "2892. The Relationship Between Inpatient and Post-discharge Antimicrobial Use at the Hospital-level Across an Integrated Healthcare Network." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S79—S80. http://dx.doi.org/10.1093/ofid/ofz359.170.

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Abstract Background Hospital-based antimicrobial stewardship interventions and metrics have typically focused only on inpatient antimicrobial exposure. However, single-center studies have found a large portion of antimicrobial exposure occurs immediately after hospital discharge. We sought to describe antimicrobial-prescribing upon hospital discharge across the Veterans Health Administration (VHA) and to compare inpatient and post-discharge antimicrobial use at the hospital-level. Methods This retrospective study used national VHA administrative data to identify all acute-care admissions from January 1, 2014 to December 31, 2016. Post-discharge antimicrobials were defined as oral outpatient antimicrobials prescribed at the time of hospital discharge. We measured inpatient-days of therapy (DOT) and post-discharge DOTs. At the hospital-level, inpatient DOTs per 100 admissions were compared with post-discharge DOTs per 100 admissions using Spearman’s rank-order correlation. Results Among 1.7 million acute-care admissions across 122 VHA hospitals, 46.1% were administered inpatient antimicrobials and 19.9% were prescribed an oral antimicrobial at discharge. Fluoroquinolones were the most common antimicrobial prescribed at discharge among 335,396 antimicrobial prescriptions (38.3%). At the hospital-level, median inpatient antimicrobial use was 331.3 DOTs per 100 admissions (interquartile range (IQR) 284.9–367.9) and median post-discharge use was 209.5 DOTs per 100 admissions (IQR 181.5–239.6). Thirty-nine percent of the total duration of antimicrobial exposure occurred after hospital discharge. The metrics of inpatient DOTs per 100 admissions and post-discharge DOTs per 100 admissions were weakly correlated at the hospital-level (rho = 0.44, P < 0.0001). Conclusion Antimicrobial-prescribing at hospital discharge was common and contributed substantially to the total antimicrobial exposure associated with an acute-care hospital stay. A hospital’s inpatient antimicrobial use was only weakly correlated with its post-discharge antimicrobial use. Antimicrobial stewardship interventions should specifically target antimicrobial-prescribing at discharge. Disclosures All Authors: No reported Disclosures.
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Bonner, Joseph, Brandon Stange, Mindy Kjar, Margaret Reynolds, Eric Hartz, Donald Bignotti, Miriam Halimi, et al. "Interdisciplinary Plans of Care, Electronic Medical Record Systems, and Inpatient Mortality." ACI Open 02, no. 01 (January 2018): e21-e29. http://dx.doi.org/10.1055/s-0038-1653970.

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Background Interdisciplinary plans of care (IPOCs) guide care standardization and satisfy accreditation requirements. Yet patient outcomes associated with IPOC usage through an electronic medical record (EMR) are not present in the literature. EMR systems facilitate the documentation of IPOC use and produce data to evaluate patient outcomes. Objectives This article aimed to evaluate whether IPOC-guided care as documented in an EMR is associated with inpatient mortality. Methods We contrasted whether IPOC-guided care was associated with a patient being discharged alive. We further tested whether the association differed across strata of acuity levels and overall frequency of IPOC usage within a hospital. Results Our sample included 165,334 adult medical/surgical discharges for a 12-month period for 17 hospitals. All hospitals had 1 full year of EMR use antedating the study period. IPOCs guided care in 85% (140,187/165,334) of discharges. When IPOCs guided care, 2.1% (3,009/140,187) of admissions ended with the patient dying while in the hospital. Without IPOC-guided care, 4.3% (1,087/25,147) of admissions ended with the patient dying in the hospital. The relative likelihood of dying while in the hospital was lower when IPOCs guided care (odds ratio: 0.45; 99% confidence interval: 0.41–0.50). Conclusion In this observational study within a quasi-experimental setting of 17 community hospitals and voluntary usage, IPOC-guided care is associated with a decreased likelihood of patients dying while in the hospital.
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O'Shea, Eamon, Jenny Hughes, Lourde Fitzpatrick, Elizabeth Dunne, Mary O'Sullivan, and Margaret Cole. "An economic evaluation of inpatient treatment versus day hospital care for psychiatric patients." Irish Journal of Psychological Medicine 15, no. 4 (December 1998): 127–30. http://dx.doi.org/10.1017/s0790966700004821.

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AbstractObjectives: To provide a methodology for the examination of costs and clinical outcomes in two distinct care settings for psychiatric patients inpatient and day hospitals. The major emphasis is on the relationship between costs and outcomes in the two care regimes.Method: The study is a retrospective cost-effectiveness analysis. People living in Sector B catchment area in the Mid-Western Health Board who were admitted to inpatient care, or treated as day hospital patients, between June 1st 1994 -February 28th 1995 are eligible for inclusion in the study. Information on resource use and clinical outcome is available for 92 of these patients.Results: The average weekly cost of care for mentally ill patients in the inpatient setting is over twice the level of the cost of care for people attending the day hospital facility. Pay costs and hotel costs are higher in the inpatient facility. Day hospital care is also more cost-effective than inpatient care, when account is taken of the relationship between cost and clinical outcomes.Conclusion: The study supports the general literature view of the superiority of community care settings for certain categories of mentally ill people. However, the absence of randomisation in the study, incomplete data, and the retrospective nature of the analysis suggests that caution is needed in the interpretation of the results.
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Htun, Htet Lin, Lok Hang Wong, Weixiang Lian, Jocelyn Koh, Liang Tee Lee, Jun Pei Lim, Ian Leong, and Wei-yen Lim. "Functional improvement after inpatient rehabilitation in community hospitals following acute hospital care." Annals of the Academy of Medicine, Singapore 51, no. 6 (June 28, 2022): 357–59. http://dx.doi.org/10.47102/annals-acadmedsg.2021507.

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Introduction: There are limited studies exploring functional improvement in relation to characteristics of patients who, following acute hospital care, receive inpatient rehabilitation in community hospitals. We evaluated the association of acute hospital admission-related factors with functional improvement on community hospital discharge. Methods: We conducted a retrospective cohort study among patients who were transferred to community hospitals within 14-day post-discharge from acute hospital between 2016 and 2018. Modified Barthel Index (MBI) on a 100-point ordinal scale was used to assess functional status on admission to and discharge from the community hospital. We categorised MBI into 6 bands: 0–24, 25–49, 50–74, 75–90, 91–99 and 100. Multivariable logistic regression models were constructed to determine factors associated with categorical improvement in functional status, defined as an increase in at least one MBI band between admission and discharge. Results: A total of 5,641 patients (median age 77 years, interquartile range 69–84; 44.2% men) were included for analysis. After adjusting for potential confounders, factors associated with functional improvement were younger age, a higher MBI on admission, and musculoskeletal diagnosis for the acute hospital admission episode. In contrast, a history of dementia or stroke; lower estimated glomerular filtration rate; abnormal serum albumin or anaemia measured during the acute hospital episode; and diagnoses of stroke, cardiac disease, malignancy, falls or pneumonia; and other chronic respiratory diseases were associated with lower odds of functional improvement. Conclusion: Clinicians may want to take into account the presence of these high-risk factors in their patients when planning rehabilitation programmes, in order to maximise the likelihood of functional improvement. Keywords: Barthel Index, community hospitals, functional status, inpatients, rehabilitation, risk factors
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Paul, Jomon A., Benedikt Quosigk, and Leo MacDonald. "Does Hospital Status Affect Performance?" Nonprofit and Voluntary Sector Quarterly 49, no. 2 (September 27, 2019): 229–51. http://dx.doi.org/10.1177/0899764019877249.

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This article investigates the impact of hospital profit status on quality of care as measured by risk-adjusted, 30-day, inpatient readmission rates gathered by the Centers for Medicare and Medicaid Services. It also evaluates the association between inpatient readmission rates and market concentration, measured by the Herfindahl–Hirschman Index, and various hospital characteristics. It concludes that nonprofit (NP) hospitals have a statistically significant negative association with readmission rates because they can focus on their mission without intense pressure to make a profit. We find no significant association between quality of care and hospital market competitiveness nor any statistically significant evidence to reject the exogeneity assumption of NP status.
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Graham, Chris. "People’s experiences of hospital care on the weekend: secondary analysis of data from two national patient surveys." BMJ Quality & Safety 27, no. 6 (September 29, 2017): 455–63. http://dx.doi.org/10.1136/bmjqs-2016-006349.

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ObjectiveTo determine whether patients treated in hospital on the weekend report different experiences of care compared with those treated on weekdays.DesignThis is a secondary analysis of the 2014 National Health Service (NHS) adult inpatient survey and accident and emergency (A&E) department surveys. Differences were tested using independent samples t-tests and multiple regression, adjusting for patient age group, sex, ethnicity, proxy response, NHS trust, route of admission (for the inpatient survey) and destination on discharge (for the A&E survey).SettingThe inpatient survey included 154 NHS hospital trusts providing overnight care; the A&E survey 142 trusts with major emergency departments.ParticipantsThree cohorts were analysed: patients attending A&E, admitted to hospital and discharged from hospital. From the inpatient survey’s 59 083 responses, 10 382 were admitted and 11 542 discharged on weekends or public holidays. The A&E survey received 39 320 responses, including 11 542 (29.4%) who attended on the weekend or on public holidays. Weekday and weekend attendees’ response rates were similar once demographic characteristics were accounted for.Main outcome measuresFor the A&E survey, six composite dimensions covered waiting times, doctors and nurse, care and treatment, cleanliness, information on discharge, and overall experiences. For the inpatient survey, three questions covered admissions and two dimensions covered information about discharge and about medicines.ResultsPeople attending A&E on weekends were significantly more favourable about ‘doctors and nurses’ and ‘care and treatment’. Inpatients admitted via A&E on a weekend were more positive about the information given to them in A&E than others. Other dimensions showed no differences between people treated on weekdays or on weekends.ConclusionsPatients attending emergency departments or admitted to or discharged from an inpatient episode on weekends and public holidays report similar or more positive experiences of care to other patients after adjusting for patient characteristics.
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Raikar, Dayanand R., Nagendra S. Manthale, and Shrinivas R. Raikar. "Inpatient dermatological referrals in a tertiary care hospital." International Journal of Research in Dermatology 3, no. 2 (May 22, 2017): 251. http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20172206.

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<p class="abstract"><strong>Background:</strong> It is not surprising that patients hospitalized on nondermatology inpatient services are frequently found to have skin problems and present as a source of confusion for their admitting physicians. Aims and Objective: To analyse the reasons for dermatology referrals and its frequency, departments sending the referral and the impact on health care management.</p><p class="abstract"><strong>Methods:</strong> We conducted a study on 464 patient referrals over a 4‑year period. The demographic details, specialties requesting consultation, cause of referral, and dermatological advice have been recorded and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> Unspecified “skin rash” was the most common dermatologic condition for which skin referral was sought. The final diagnoses made by dermatologists revealed infections as most common skin disorder. Almost 48% of the patients referred as “skin rash” were diagnosed to be suffering from infectious disorders. The referring doctors could provide an accurate dermatological diagnosis only in 32% of cases.</p><p><strong>Conclusions:</strong> Most of the nondermatologists fail to diagnose common skin disorders. This reveals need for more trained dermatologists to combat this problem and more extensive dermatological training for the medical students.</p>
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&NA;. "Costs decline for most HIV hospital inpatient care." Nursing Management (Springhouse) 32 (June 2001): 26. http://dx.doi.org/10.1097/00006247-200106000-00013.

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Neill, Daniel B. "Using Artificial Intelligence to Improve Hospital Inpatient Care." IEEE Intelligent Systems 28, no. 2 (March 2013): 92–95. http://dx.doi.org/10.1109/mis.2013.51.

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Kashiwagi, Deanne T. "Geriatric inpatient care: what should hospital clinicians know?" Hospital Practice 48, sup1 (February 8, 2020): 1–2. http://dx.doi.org/10.1080/21548331.2020.1723354.

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Mathews, Dwight, Lisa Levin, Yevgeniy Latyshev, Mailha Ahmed, Sameen Rahman, and Ziauddin Ahmed. "194 Inadequate Inpatient ESRD Care in Teaching Hospital." American Journal of Kidney Diseases 57, no. 4 (April 2011): B65. http://dx.doi.org/10.1053/j.ajkd.2011.02.197.

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Hine, Christine, Victorine A. Wood, Stephen Taylor, and Mark Charny. "Do Community Hospitals Reduce the Use of District General Hospital Inpatient beds?" Journal of the Royal Society of Medicine 89, no. 12 (December 1996): 681–87. http://dx.doi.org/10.1177/014107689608901207.

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Community hospitals have been supported by the general public and by professionals as one means of increasing choice between local, low technology, care and high technology care at the district general hospital. However, there is no information on the impact of community hospitals on district general hospital use subsequent to NHS and community care reforms. Examination of routinely gathered activity data in the Bath Health District revealed that availability of community hospital beds was associated with reduced use of central inpatient services in the city of Bath. The reduction was most apparent for medical and geriatric beds. Decrease in the use of surgical beds was small. However, total inpatient bed use (including central and community hospital beds) was higher in the population with access to community hospital beds. We conclude that community hospitals offer one option for accessible health care and, as such, merit systematic evaluation of costs and benefits. This study presents some evidence that savings could be achieved through improved efficiency.
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O’Connell, James A., Eoghan de barra, and Samuel McConkey. "1664. The Utilization of Hospital Inpatient Care due to Tuberculosis, Republic of Ireland, 2015-2018." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S819. http://dx.doi.org/10.1093/ofid/ofaa439.1842.

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Abstract Background The Republic of Ireland (ROI) is a low incidence TB country. The last reform of TB services in the ROI in 2003 recommended that most TB management should be delivered on an outpatient basis with 3 hospitals being designated as TB centres. Our aim was to describe the utilization of hospital inpatient care by patients with TB in the Republic of Ireland. Methods Hospital coding data were searched to identify TB hospital discharges between 01/01/2015-31/12/18. The projected cost of TB episodes of care was calculated using payment rules for public hospitals in Ireland. Results 1185 admissions with TB as the principal diagnosis were identified. 801/1185 (68%) episodes of care were emergencies and 384/1185 (32%) were elective We estimate that 65.1% (818/1257) patients with TB notified in the Republic of Ireland from 2015-2018 had an episode of care in a public hospital and (50.8%) 639/818 had an emergency episode of care. We estimate that mean annual cost of TB inpatient care per year in the ROI from 2015-2018 was €2,638,828 - 2,955,047, with emergency episodes of care costing an average of €2,250,926 - 2,557,397 per year. Conclusion The burden of TB on hospital inpatient care in the Republic of Ireland is significant. The national TB policy should change in recognition of this. Disclosures All Authors: No reported disclosures
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