BACKGROUND: Pneumonia is a common reason for hospital admission, and the cost of treatment is primarily determined by length of stay (LOS). OBJECTIVES: To explore the changes to and determinants of hospital LOS for patients admitted for the treatment of community-acquired pneumonia over a decade of acute hospital downsizing. METHODS: Data were extracted from the database of Vancouver General Hospital, Vancouver, British Columbia, on patients admitted with community-acquired pneumonia (International Classification of Diseases, Ninth Revision, Clinical Modification codes 481.xx, 482.xx, 483.xx, 485.xx and 486.xx) from January 1, 1991 to March 31, 2001. The effects of sociodemographic factors, the specialty of the admitting physician (family practice versus specialist), admission from and/or discharge to a long-term care facility (nursing home) and year of admission, adjusted for comorbidity, illness severity measures and other potential confounders were examined. Longitudinal changes in these factors over the 10-year period were also investigated. RESULTS: The study population (n=2495) had a median age of 73 years, 53% were male and the median LOS was six days. Adjusted LOS was longer for women (10% increase, 95% CI 3 to 16), increasing age group (7% increase, 95% CI 4 to 10), admission under a family physician versus specialist (42% increase, 95% CI 32 to 52) and admission from home with subsequent discharge to a long-term care facility (75% increase, 95% CI 47 to 108). Adjusted hospital LOS decreased by an estimated 2% (95% CI 1 to 3) per annum. The mean age at admission and the proportion admitted from long-term care facilities both increased significantly over the decade (P<0.05). CONCLUSIONS: Results suggest that the management of hospitalized patients with pneumonia changed substantially between 1991 and 2001. The interface of long-term care facilities with acute care would be an important future area to explore potential efficiencies in caring for patients with pneumonia.
BACKGROUND:Pneumonia is a common reason for hospital admission, and the cost of treatment is primarily determined by length of stay (LOS). OBJECTIVES: To explore the changes to and determinants of hospital LOS for patients admitted for the treatment of community-acquired pneumonia over a decade of acute hospital downsizing. METHODS: Data were extracted from the database of Vancouver General Hospital, Vancouver, British Columbia, on patients admitted with community-acquired pneumonia (International Classification of Diseases, Ninth Revision, Clinical Modification codes 481.xx, 482.xx, 483.xx, 485.xx and 486.xx) from January 1, 1991 to March 31, 2001. The effects of sociodemographic factors, the specialty of the admitting physician (family practice versus specialist), admission from and/or discharge to a long-term care facility (nursing home) and year of admission, adjusted for comorbidity, illness severity measures and other potential confounders were examined. Longitudinal changes in these factors over the 10-year period were also investigated. RESULTS: The study population (n=2495) had a median age of 73 years, 53% were male and the median LOS was six days. Adjusted LOS was longer for women (10% increase, 95% CI 3 to 16), increasing age group (7% increase, 95% CI 4 to 10), admission under a family physician versus specialist (42% increase, 95% CI 32 to 52) and admission from home with subsequent discharge to a long-term care facility (75% increase, 95% CI 47 to 108). Adjusted hospital LOS decreased by an estimated 2% (95% CI 1 to 3) per annum. The mean age at admission and the proportion admitted from long-term care facilities both increased significantly over the decade (P<0.05). CONCLUSIONS: Results suggest that the management of hospitalized patients with pneumonia changed substantially between 1991 and 2001. The interface of long-term care facilities with acute care would be an important future area to explore potential efficiencies in caring for patients with pneumonia.
Authors: Maria C Rodriguez-Barradas; Kathleen A McGinnis; Kathleen Akgün; Janet P Tate; Sheldon T Brown; Adeel A Butt; Michael Fine; Matthew Bidwell Goetz; Christopher J Graber; Laurence Huang; David Rimland; Amy Justice; Kristina Crothers Journal: Pneumonia (Nathan) Date: 2020-07-25
Authors: Daniel Widmer; Daniel Drozdov; Kristina Rüegger; Alexander Litke; Birsen Arici; Katharina Regez; Merih Guglielmetti; Ursula Schild; Antoinette Conca; Petra Schäfer; Rita Bossart Kouegbe; Barbara Reutlinger; Claudine Blum; Philipp Schuetz; Sarosh Irani; Andreas Huber; Ulrich Bürgi; Beat Müller; Werner C Albrich Journal: J Clin Med Date: 2014-03-14 Impact factor: 4.241
Authors: Werner C Albrich; Kristina Rüegger; Frank Dusemund; Philipp Schuetz; Birsen Arici; Alexander Litke; Claudine A Blum; Rita Bossart; Katharina Regez; Ursula Schild; Merih Guglielmetti; Antoinette Conca; Petra Schäfer; Maria Schubert; Sabina de Geest; Barbara Reutlinger; Sarosh Irani; Ulrich Bürgi; Andreas Huber; Beat Müller Journal: Eur Respir J Date: 2013-01-24 Impact factor: 16.671