ArticleAnnals of the American Thoracic Society2019
Comparison of Care Patterns and Rehospitalizations for Mechanically Ventilated Patients in New York and Ontario.
Article in Annals of the American Thoracic Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Regional Differences in Outcomes for Patients Undergoing Transcatheter Aortic Valve Replacement in New York State and Ontario.The Canadian journal of cardiology · 2023Observational
- Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.BMJ quality & safety · 2021Article
- Mechanical Ventilation Survivorship: A Tale of Two Countries.Annals of the American Thoracic Society · 2019Article
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5 authors.
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Abstract
rationaleMechanically ventilated patients require complex care and are at high risk for rehospitalization, but different systems of care may result in different hospital discharge practices and rates of rehospitalization.
objectivesTo compare lengths of hospitalization, discharge patterns, and rehospitalization rates in New York in the United States and Ontario in Canada.
methodsWe conducted a retrospective cohort study of mechanically ventilated patients who survived an acute care hospitalization in New York or Ontario from 2010 to 2012, using linkable administrative healthcare data.
resultsThe primary outcome was the cumulative incidence of first rehospitalization within 30 days of discharge, accounting for the competing risk of death. Of 71,063 mechanically ventilated patients in New York, and 41,875 in Ontario who survived to hospital discharge, median length of initial hospital stay was similar in New York and Ontario (15 d, interquartile range = 8-28 vs. 16 d [9-30]), but was systematically shorter in New York when stratified by patient subgroups of different illness severity. Fewer patients in New York were discharged directly home (53.6% vs. 71.4%). Of patients in New York, 15,527 (cumulative incidence 21.9%) had a first rehospitalization within 30 days versus 5,580 (cumulative incidence 13.3%) in Ontario (P < 0.001). Incidence of rehospitalization was higher in New York across all subgroups assessed, with the greatest differences among patients with a tracheostomy (29.8% vs. 13.3%, P < 0.001), those who received dialysis during the hospitalization (31.9% vs. 17.4%, P < 0.001), and for patients not discharged directly home (27.6% vs. 13.3%, P < 0.001).
conclusionsCare patterns for mechanically ventilated patients in New York and Ontario are very different; mechanically ventilated patients who survive to hospital discharge in New York have shorter hospital stays, with higher rehospitalization rates within 30 days compared with Ontario.
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