Leveraging Social Determinants of Health to Reduce Hospital Length of Stay: A Pilot QI Project for Solid Tumor Oncology Patients During the COVID-19 Pandemic.
| Autor: | Kamaraju T; Medical College of Wisconsin, Milwaukee, Wisconsin, skamaraju@mcw.edu., Atkinson D; Froedtert Hospital, Milwaukee, Wisconsin., Wright T; Froedtert Hospital, Milwaukee, Wisconsin., Charlosn J; Medical College of Wisconsin, Milwaukee, Wisconsin., Wetzel T; Froedtert Hospital, Milwaukee, Wisconsin., Campbell G; Duquesne University, Pittsburgh, Pennsylvania., Cadman J; Froedtert Hospital, Milwaukee, Wisconsin., Williams J; Medical College of Wisconsin, Milwaukee, Wisconsin., Egede L; Medical College of Wisconsin, Milwaukee, Wisconsin., Retseck J; Medical College of Wisconsin, Milwaukee, Wisconsin., Banerjee A; Medical College of Wisconsin, Milwaukee, Wisconsin., Ehrlich V; Medical College of Wisconsin, Milwaukee, Wisconsin., Stolley M; Medical College of Wisconsin, Milwaukee, Wisconsin., Power S; Duke Cancer Institute, Duke University Hospital, Durham, North Carolina. |
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| Jazyk: | angličtina |
| Zdroj: | WMJ : official publication of the State Medical Society of Wisconsin [WMJ] 2022 Oct; Vol. 121 (3), pp. 205-211. |
| Abstrakt: | Purpose: The impact of the social determinants of health (SDOH) on hospitalized cancer patients and hospital length of stay is unknown. At our institution, a hospital-wide SDOH survey that examined patient-specific barriers to various domains of SDOH and facilitated hospital discharge was integrated into the electronic medical record. This study reports the effect of the SDOH survey on length of stay for oncology patients and the outpatient referrals generated to facilitate the discharge. Methods: We examined length of stay index data on inpatient oncology patients and 2 comparator services (bone marrow transplant, internal medicine). We evaluated the length of stay using a 2-sample t test, and the rate of referrals per discharge using a 2-sample Poisson test. Results: Compared to the baseline length of stay, after the launch of the SDOH survey, there was a significant (8.9%) decrease in the average length of stay for oncology patients (8.14 to 7.41 days, P = 0.004), the LOS decrease for the bone marrow transplant and subset was a nonsignificant trend only ( P > 0.1). Average referrals per discharge increased from baseline 1.063 per discharge to 1.159 after implementation ( P = 0.004), and the mean values increased by 9%. Conclusions: The SDOH survey tool assisted in a timely examination of patient-specific barriers to discharge, leveraged care coordination, and facilitated a safe hospital discharge. Such efforts increase the efficiency of health care service delivery in response to public health threats, such as the COVID-19 pandemic. (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.) |
| Databáze: | MEDLINE |
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