Evidence map›Paper›PMID 26603353›Full record

ArticleRevista de saude publica2015

Impact of long-stay beds on the performance of a tertiary hospital in emergencies.

Antonio Pazin-Filho, Edna de Almeida, Leni Peres Cirilo, Frederica Montanari Lourençato, Lisandra Maria Baptista, José Paulo Pintyá, Ronaldo Dias Capeli, Sonia Maria Pirani Felix da Silva, Claudia Maria Wolf, Marcelo Marcos Dinardi and 2 more

Abstract read
In one paragraph

Article in Revista de saude publica, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Palliative care team in a Brazilian tertiary emergency department.International journal of emergency medicine · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Antonio Pazin-FilhoDepartamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Edna de AlmeidaFaculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Leni Peres CiriloFaculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Frederica Montanari LourençatoFaculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Lisandra Maria BaptistaFaculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
José Paulo PintyáFaculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Ronaldo Dias CapeliDepartamento Regional de Saúde XIII, Secretaria de Saúde do Estado de São Paulo, Ribeirão Preto, SP, Brasil.
Sonia Maria Pirani Felix da SilvaDepartamento Regional de Saúde XIII, Secretaria de Saúde do Estado de São Paulo, Ribeirão Preto, SP, Brasil.
Claudia Maria WolfDepartamento Regional de Saúde XIII, Secretaria de Saúde do Estado de São Paulo, Ribeirão Preto, SP, Brasil.
Marcelo Marcos DinardiDepartamento Regional de Saúde XIII, Secretaria de Saúde do Estado de São Paulo, Ribeirão Preto, SP, Brasil.
Sandro ScarpeliniDepartamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Maria Cecília DamascenoDepartamento Clínico-Cirúrgico, Faculdade de Medicina do ABC, São Paulo, SP, Brasil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the impact of implementing long-stay beds for patients of low complexity and high dependency in small hospitals on the performance of an emergency referral tertiary hospital.

methodsFor this longitudinal study, we identified hospitals in three municipalities of a regional department of health covered by tertiary care that supplied 10 long-stay beds each. Patients were transferred to hospitals in those municipalities based on a specific protocol. The outcome of transferred patients was obtained by daily monitoring. Confounding factors were adjusted by Cox logistic and semiparametric regression.

resultsBetween September 1, 2013 and September 30, 2014, 97 patients were transferred, 72.1% male, with a mean age of 60.5 years (SD = 1.9), for which 108 transfers were performed. Of these patients, 41.7% died, 33.3% were discharged, 15.7% returned to tertiary care, and only 9.3% tertiary remained hospitalized until the end of the analysis period. We estimated the Charlson comorbidity index - 0 (n = 28 [25.9%]), 1 (n = 31 [56.5%]) and ≥ 2 (n = 19 [17.5%]) - the only variable that increased the chance of death or return to the tertiary hospital (Odds Ratio = 2.4; 95%CI 1.3;4.4). The length of stay in long-stay beds was 4,253 patient days, which would represent 607 patients at the tertiary hospital, considering the average hospital stay of seven days. The tertiary hospital increased the number of patients treated in 50.0% for Intensive Care, 66.0% for Neurology and 9.3% in total. Patients stayed in long-stay beds mainly in the first 30 (50.0%) and 60 (75.0%) days.

conclusionsImplementing long-stay beds increased the number of patients treated in tertiary care, both in general and in system bottleneck areas such as Neurology and Intensive Care. The Charlson index of comorbidity is associated with the chance of patient death or return to tertiary care, even when adjusted for possible confounding factors.

Indexed as

AgedComorbidityFemaleHospital MortalityHumansIntensive Care UnitsLength of StayLong-Term CareMaleNational Health ProgramsPatient AdmissionPatient TransferTertiary Care Centers

Identifiers

PMID26603353
PMCPMC4650935

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.