Observation Encounters and Length of Stay Benchmarking in Children’s Hospitals
| Autor: | Rustin Morse, Matthew Hall, Michelle L. Macy, Evan S. Fieldston, David C. Synhorst |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Adolescent Hospitalized patients Outpatient service Resource Allocation Young Adult Clinical Observation Units medicine Humans Inpatient status Child Quality of Health Care Retrospective Studies business.industry Infant Newborn Infant Retrospective cohort study Benchmarking Length of Stay Hospitals Pediatric Patient Discharge United States Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Hospital Information Systems Resource use business |
| Zdroj: | Pediatrics. 146 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2020-0120 |
| Popis: | BACKGROUND AND OBJECTIVES:Length of stay (LOS) is a common benchmarking measure for hospital resource use and quality. Observation status (OBS) is considered an outpatient service despite the use of the same facilities as inpatient status (IP) in most children’s hospitals, and LOS calculations often exclude OBS stays. Variability in the use of OBS by hospitals may significantly impact calculated LOS. We sought to determine the impact of including OBS in calculating LOS across children’s hospitals.METHODS:Retrospective cohort study of hospitalized children (age RESULTS:In 2017, 45 hospitals and 625 032 hospitalizations met inclusion criteria (IP = 410 731 [65.7%], OBS = 214 301 [34.3%]). Across hospitals, OBS represented 0.0% to 60.3% of total discharges. The RA-LOS (SD) in hours for IP and IP plus OBS was 75.2 (2.6) and 54.3 (2.7), respectively (P < .001). For hospitals reporting OBS, the addition of OBS to IP RA-LOS calculations resulted in a decrease in RA-LOS compared with IP encounters alone. Three-fourths of hospitals changed ≥1 quintile in LOS ranking with the inclusion of OBS.CONCLUSIONS:Children’s hospitals exhibit significant variability in the assignment of OBS to hospitalized patients and inclusion of OBS significantly impacts RA-LOS calculations. Careful consideration should be given to the inclusion of OBS when determining RA-LOS for benchmarking, quality and resource use measurements. |
| Databáze: | OpenAIRE |
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