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The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia

Background: Limited available evidence suggests that a small proportion of inpatients undergo prolonged hospitalization and use a disproportionate number of bed days. Understanding the factors contributing to prolonged hospitalization may improve patient care and reduce the length of stay in such pa...

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Autores principales: Ofori-Asenso, Richard, Liew, Danny, Mårtensson, Johan, Jones, Daryl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564707/
https://www.ncbi.nlm.nih.gov/pubmed/32971851
http://dx.doi.org/10.3390/jcm9093055
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author Ofori-Asenso, Richard
Liew, Danny
Mårtensson, Johan
Jones, Daryl
author_facet Ofori-Asenso, Richard
Liew, Danny
Mårtensson, Johan
Jones, Daryl
author_sort Ofori-Asenso, Richard
collection PubMed
description Background: Limited available evidence suggests that a small proportion of inpatients undergo prolonged hospitalization and use a disproportionate number of bed days. Understanding the factors contributing to prolonged hospitalization may improve patient care and reduce the length of stay in such patients. Methods: We undertook a retrospective cohort study of adult (≥20 years) patients admitted for at least 24 h between 14 November 2016 and 14 November 2018 to hospitals in Victoria, Australia. Data including baseline demographics, admitting specialty, survival status and discharge disposition were obtained from the Victorian Admission Episode Dataset. Multivariable logistic regression analysis was used to identify factors independently associated with prolonged hospitalization (≥14 days). Cox proportional hazard regression model was used to examine the association between various factors and in-hospital mortality. Results: There were almost 5 million hospital admissions over two years. After exclusions, 1,696,112 admissions lasting at least 24 h were included. Admissions with prolonged hospitalization comprised only 9.7% of admissions but utilized 44.2% of all hospital bed days. Factors independently associated with prolonged hospitalization included age, female gender, not being in a relationship, being a current smoker, level of co-morbidity, admission from another hospital, admission on the weekend, and the number of admissions in the prior 12 months. The in-hospital mortality rate was 5.0% for those with prolonged hospitalization compared with 1.8% in those without (p < 0.001). Prolonged hospitalization was also independently associated with a decreased likelihood of being discharged to home (OR 0.53, 95% CI 0.52–0.54). Conclusions: Patients experiencing prolonged hospitalization utilize a disproportionate proportion of bed days and are at higher risk of in-hospital death and discharge to destinations other than home. Further studies are required to identify modifiable factors contributing to prolonged hospitalization as well as the quality of end-of-life care in such admissions.
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spelling pubmed-75647072020-10-29 The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia Ofori-Asenso, Richard Liew, Danny Mårtensson, Johan Jones, Daryl J Clin Med Article Background: Limited available evidence suggests that a small proportion of inpatients undergo prolonged hospitalization and use a disproportionate number of bed days. Understanding the factors contributing to prolonged hospitalization may improve patient care and reduce the length of stay in such patients. Methods: We undertook a retrospective cohort study of adult (≥20 years) patients admitted for at least 24 h between 14 November 2016 and 14 November 2018 to hospitals in Victoria, Australia. Data including baseline demographics, admitting specialty, survival status and discharge disposition were obtained from the Victorian Admission Episode Dataset. Multivariable logistic regression analysis was used to identify factors independently associated with prolonged hospitalization (≥14 days). Cox proportional hazard regression model was used to examine the association between various factors and in-hospital mortality. Results: There were almost 5 million hospital admissions over two years. After exclusions, 1,696,112 admissions lasting at least 24 h were included. Admissions with prolonged hospitalization comprised only 9.7% of admissions but utilized 44.2% of all hospital bed days. Factors independently associated with prolonged hospitalization included age, female gender, not being in a relationship, being a current smoker, level of co-morbidity, admission from another hospital, admission on the weekend, and the number of admissions in the prior 12 months. The in-hospital mortality rate was 5.0% for those with prolonged hospitalization compared with 1.8% in those without (p < 0.001). Prolonged hospitalization was also independently associated with a decreased likelihood of being discharged to home (OR 0.53, 95% CI 0.52–0.54). Conclusions: Patients experiencing prolonged hospitalization utilize a disproportionate proportion of bed days and are at higher risk of in-hospital death and discharge to destinations other than home. Further studies are required to identify modifiable factors contributing to prolonged hospitalization as well as the quality of end-of-life care in such admissions. MDPI 2020-09-22 /pmc/articles/PMC7564707/ /pubmed/32971851 http://dx.doi.org/10.3390/jcm9093055 Text en © 2020 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 Article
Ofori-Asenso, Richard
Liew, Danny
Mårtensson, Johan
Jones, Daryl
The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia
title The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia
title_full The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia
title_fullStr The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia
title_full_unstemmed The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia
title_short The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia
title_sort frequency of, and factors associated with prolonged hospitalization: a multicentre study in victoria, australia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564707/
https://www.ncbi.nlm.nih.gov/pubmed/32971851
http://dx.doi.org/10.3390/jcm9093055
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