ArticleBMC emergency medicine2016
Outcomes associated with observation versus short-stay admission among chest pain patients in the Veterans Health Administration.
Article in BMC emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed, 4 citations in OpenAlex.
- Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.BMC health services research · 2020Article
- Observation Versus Inpatient Stay for Heart Failure: Is It Semantics?Journal of the American Heart Association · 2018Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo determine the extent to which 30- and 90-day hospital readmission and mortality rates differ as a function of whether a chest pain patient is placed in observation status or admitted to the hospital for a short-stay (<48 h).
methodsUsing 114,043 observation stays and short-stay admissions for chest pain at Veterans Health Administration hospitals between 2005 and 2013, we estimated event-level logistic regression models using a generalized estimating equation framework to predict 30 and 90-day readmissions and mortality as a function of whether the patient had an observation stay or a short-stay admission. We also adjusted for a variety of patient characteristics and unobserved time-invariant hospital factors.
resultsRelative to the short-stay inpatient group, veterans with chest pain who were placed in observation status were significantly more likely to be female (7.0 % vs. 6.4 %, White (76.6 % vs. 71.0 %, and from a rural area (28.3 % vs. 20.2 %). There were no other meaningful differences between the groups. Veterans with chest pain who were placed in observation status had 25 % lower odds of dying within 30 days (95 % confidence interval [CI]: 3 % - 43 %) and 12 % lower odds of a 30-day readmission (95 % CI: 6 % - 17 %) compared to those admitted as short-stay inpatients. Neither 90-day outcome was significantly associated with placement in observation status. Patient demographics were also important predictors of mortality and readmissions.
conclusionsThere are clinically observable differences in outcomes between patients admitted to observation and those admitted as short-stay inpatients. We find no evidence that the increase in observation stays reflects a lack of proper care for patients placed in observation status.
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