The epidemiology of long stay patients in a university teaching hospital.
Intern Med J. 2017 Feb 01;:
Authors: O'Sullivan K, Martensson J, Robbins R, Farley KJ, Johnson D, Jones D
BACKGROUND: Patients admitted to acute care hospitals may have multiple co-morbidities, and a small proportion may stay a protracted period.
AIMS: To assess the proportion of hospital patients who are long stay (≥14 days), evaluate associations with baseline variables and subsequent in-patient morbidity and mortality.
METHODS: Retrospective observational study of patients aged ≥ 18 years staying in hospital for at least 24 hr between 1-7-2013 and 30-6-2014.
RESULTS: There were 22,094 admissions in 15,623 patients. The median (IQR) length of stay was 4 (2-8) days, and 10% had a length of stay > 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, to die in hospital (8.2% vs 3.1%), and 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 co-morbidity index at admission, admission from another hospital, and any history of smoking.
CONCLUSIONS: Patients staying at least 14 days comprised one seventh of hospital admissions, but used half of bed days, and suffer increased in-hospital morbidity and mortality. Several pre-admission associations with prolonged stay were identified.
PMID: 28145035 [PubMed - as supplied by publisher]