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Who Has an Unsuccessful Observation Care Stay?
Background: With the recent increase use of observation care, it is important to understand the characteristics of patients that utilize this care and either have a prolonged observation care stay or require admission. Methods: We a conducted a retrospective cohort study utilizing 5% sample data fro...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316509/ https://www.ncbi.nlm.nih.gov/pubmed/30486381 http://dx.doi.org/10.3390/healthcare6040138 |
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author | Gabayan, Gelareh Z. Doyle, Brian Liang, Li-Jung Donkor, Kwame Huang, David Yu-Chuang Sarkisian, Catherine A. |
author_facet | Gabayan, Gelareh Z. Doyle, Brian Liang, Li-Jung Donkor, Kwame Huang, David Yu-Chuang Sarkisian, Catherine A. |
author_sort | Gabayan, Gelareh Z. |
collection | PubMed |
description | Background: With the recent increase use of observation care, it is important to understand the characteristics of patients that utilize this care and either have a prolonged observation care stay or require admission. Methods: We a conducted a retrospective cohort study utilizing 5% sample data from Medicare patients age ≥65 years that was nationally representative in the year 2013. We performed a generalized estimating equation (GEE) logistic regression analysis to evaluate the relationship between an unsuccessful observation stay (defined as either requiring an inpatient admission from observation or having a prolonged observation stay) compared to having successful observation care. Observation cut offs of “successful” vs. “unsuccessful” were based on the CMS 2 midnight rule. Results: Of 154,756 observation stays in 2013, 19 percent (n = 29,604) were admitted to the inpatient service and 34,275 (22.2%) had a prolonged observation stay. The two diagnoses most likely to have an unsuccessful observation stay were intestinal infections (OR 1.56, 95% CI 1.32–1.83) and pneumonia (OR 1.26, 95% CI 1.13–1.41). Conclusion: We found patients placed in observation care with intestinal infections and pneumonia to have the highest odds of either being admitted from observation or having a prolonged observation stay. |
format | Online Article Text |
id | pubmed-6316509 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-63165092019-01-07 Who Has an Unsuccessful Observation Care Stay? Gabayan, Gelareh Z. Doyle, Brian Liang, Li-Jung Donkor, Kwame Huang, David Yu-Chuang Sarkisian, Catherine A. Healthcare (Basel) Project Report Background: With the recent increase use of observation care, it is important to understand the characteristics of patients that utilize this care and either have a prolonged observation care stay or require admission. Methods: We a conducted a retrospective cohort study utilizing 5% sample data from Medicare patients age ≥65 years that was nationally representative in the year 2013. We performed a generalized estimating equation (GEE) logistic regression analysis to evaluate the relationship between an unsuccessful observation stay (defined as either requiring an inpatient admission from observation or having a prolonged observation stay) compared to having successful observation care. Observation cut offs of “successful” vs. “unsuccessful” were based on the CMS 2 midnight rule. Results: Of 154,756 observation stays in 2013, 19 percent (n = 29,604) were admitted to the inpatient service and 34,275 (22.2%) had a prolonged observation stay. The two diagnoses most likely to have an unsuccessful observation stay were intestinal infections (OR 1.56, 95% CI 1.32–1.83) and pneumonia (OR 1.26, 95% CI 1.13–1.41). Conclusion: We found patients placed in observation care with intestinal infections and pneumonia to have the highest odds of either being admitted from observation or having a prolonged observation stay. MDPI 2018-11-27 /pmc/articles/PMC6316509/ /pubmed/30486381 http://dx.doi.org/10.3390/healthcare6040138 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Project Report Gabayan, Gelareh Z. Doyle, Brian Liang, Li-Jung Donkor, Kwame Huang, David Yu-Chuang Sarkisian, Catherine A. Who Has an Unsuccessful Observation Care Stay? |
title | Who Has an Unsuccessful Observation Care Stay? |
title_full | Who Has an Unsuccessful Observation Care Stay? |
title_fullStr | Who Has an Unsuccessful Observation Care Stay? |
title_full_unstemmed | Who Has an Unsuccessful Observation Care Stay? |
title_short | Who Has an Unsuccessful Observation Care Stay? |
title_sort | who has an unsuccessful observation care stay? |
topic | Project Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316509/ https://www.ncbi.nlm.nih.gov/pubmed/30486381 http://dx.doi.org/10.3390/healthcare6040138 |
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