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The epidemiology of long stay patients in a university teaching hospital.

The epidemiology of long stay patients in a university teaching hospital.
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O'Sullivan K, Martensson J, Robbins R, Farley KJ, Johnson D, Jones D,


O'Sullivan K, Martensson J, Robbins R, Farley KJ, Johnson D, Jones D, (click to view)

O'Sullivan K, Martensson J, Robbins R, Farley KJ, Johnson D, Jones D,

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Internal medicine journal 2017 02 01() doi 10.1111/imj.13379
Abstract
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.

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