Factors associated with prolonged length of hospital stay of elderly patients in acute care hospitals in Japan: A multilevel analysis of patients with femoral neck fracture
| Autor: | T Motohashi, Hironori Hamada, Jason Lee, Miho Sekimoto, Yuichi Imanaka |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty MEDLINE Hospitals Special Nursing care Sex Factors Japan Acute care Health care medicine Humans Intensive care medicine Patient transfer Aged Bed Occupancy Femoral neck Aged 80 and over Hip fracture business.industry Health Policy Multilevel model Age Factors Length of Stay medicine.disease Patient Discharge Femoral Neck Fractures Nursing Homes medicine.anatomical_structure Female business |
| Zdroj: | Health Policy. 111:60-67 |
| ISSN: | 0168-8510 |
| DOI: | 10.1016/j.healthpol.2013.03.014 |
| Popis: | Objective To analyze possible factors associated with prolonged length of stay (LOS) in hip fracture patients in Japan, such as the availability of beds in medical and nursing care facilities at the community level, as well as patient factors, clinical factors and hospital structural characteristics. Methods The sample for analysis consisted of 8318 hip fracture cases from 199 hospitals throughout Japan. We conducted multilevel analyses to investigate whether LOS and the discharge destinations of patients are associated with the availability and utilization of medical and nursing care resources in the communities where each hospital is located. Results After adjusting for patient factors, clinical factors and hospital structural characteristics, a higher number of long-term care beds at the community level was observed to be significantly correlated with both shorter LOS and increased rate of discharge to other facilities. Discussion and conclusion Although the Japanese government is attempting to reduce acute care hospital LOS and the number of long-term care beds in order to reduce health care costs, the results of this study suggest that a reduction in the number of long-term care beds would not necessarily reduce the LOS of acute care hospitals, and may instead exacerbate the problem. |
| Databáze: | OpenAIRE |
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