Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/17926
Title: Epidemiology of long-stay patients in a university teaching hospital.
Austin Authors: O'Sullivan, Kim;Martensson, Johan;Robbins, Raymond J ;Farley, K J;Johnson, Douglas F;Jones, Daryl A 
Affiliation: Director Patient Flow, Austin Health, Heidelberg, Victoria, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Section of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
Department of Administrative Informatics, Austin Health, Heidelberg, Victoria, Australia
Intensive Care, Western Health, Melbourne, Victoria, Australia
Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
Issue Date: May-2017
Publication information: Internal Medicine Journal 2017-05; 47(5): 513-521
Abstract: Patients admitted to acute care hospitals may have multiple comorbidities, and a small proportion may stay for a protracted period. To assess the proportion of hospital patients who are long stay (≥14 days) and evaluate associations with baseline variables and subsequent inpatient morbidity and mortality. This is a retrospective observational study of patients aged ≥18 years staying in hospital for at least 24 h between 1 July 2013 and 30 June 2014. There were 22 094 admissions in 15 623 patients. The median (interquartile range (IQR)) length of stay (LOS) was 4 (2-8) days, and 10% had a LOS >16 days. Long-stay admissions comprised 13.1% of admissions but used 49.1% of bed days. Long-stay admissions were more likely to be associated with intensive care unit admission (21.2 vs 6.0%), medical emergency team review (20.5 vs 4.3%) and a longer duration of mechanical ventilation (P < 0.0001 all comparisons). Long-stay patients were more likely to develop in-hospital complications, were more likely to die in hospital (8.2 vs 3.1%) and were less likely to be discharged home (P < 0.001 all comparisons). Multiple variable analysis revealed several associations with prolonged stay, including multiple admissions in the study period, the nature of the admitting unit, the Charlson comorbidity index at admission, admission from another hospital and any history of smoking. Patients staying at least 14 days comprised one seventh of hospital admissions but used half of bed days and suffered increased in-hospital morbidity and mortality. Several pre-admission associations with prolonged stay were identified.
URI: https://ahro.austin.org.au/austinjspui/handle/1/17926
DOI: 10.1111/imj.13379
ORCID: 0000-0001-8739-7896
Journal: Internal Medicine Journal
PubMed URL: 28145035
Type: Journal Article
Subjects: long stay
morbidity
patient complexity
Appears in Collections:Journal articles

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