Evidence map›Paper›PMID 30692151›Full record

ArticleCMAJ open

Characteristics of short general internal medicine hospital stays: a multicentre cross-sectional study.

Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Fahad Razak

Abstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Observational
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

8 authors.

Amol A VermaLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass. amol.verma@mail.utoronto.ca.
Yishan GuoLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass.
Janice L KwanLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass.
Lauren Lapointe-ShawLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass.
Shail RawalLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass.
Terence TangLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass.
Adina WeinermanLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass.
Fahad RazakLi Ka Shing Knowledge Institute (Verma, Guo, Razak), St. Michael's Hospital; Department of Medicine (Verma, Kwan, Lapointe-Shaw, Rawal, Tang, Weinerman, Razak) and Institute of Health Policy, Management and Evaluation (Razak), University of Toronto; Department of Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Rawal), University Health Network, Toronto, Ont.; Trillium Health Partners (Tang), Mississauga, Ont.; Sunnybrook Health Sciences Centre (Weinerman), Toronto, Ont.; Harvard Center for Population and Development Studies (Razak), Cambridge, Mass.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundShort hospital stays may represent opportunities to avert unnecessary admissions or expedite inpatient care. To inform the design of interventions that target patients with potentially avoidable hospital admissions or brief stays, we examined the patient, physician and situational characteristics associated with short stays among patients admitted to general internal medicine wards and describe the use of hospital resources by these patients.

methodsThis was a multicentre cross-sectional study conducted between Apr. 1, 2012, and Mar. 31, 2015, at 5 teaching hospitals in Toronto. We included all general internal medicine admissions through the emergency department. We examined patient, physician and situational predictors of a short hospital stay, which was defined as the patient's being discharged home alive in 2 possible time windows: less than 24 hours, or 72 hours or less.

resultsThe final study sample included 56 055 admissions and 37 700 unique patients. Patients discharged in less than 24 hours and in 72 hours or less accounted for 4245 (7.6%) and 13 442 (31.6%) admissions, respectively. After we controlled for patient factors, patients of female physicians were less likely than those of male physicians to have stays lasting less than 24 hours (adjusted odds ratio [OR] 0.80, 95% confidence interval [CI] 0.74-0.86) or 72 hours or less (adjusted OR 0.82, 95% CI 0.79-0.86). Patients admitted at night or on a weekday were significantly more likely than those admitted at other times to have stays lasting less than 24 hours (night: adjusted OR 2.73, 95% CI 2.44-3.06; weekday: adjusted OR 1.26, 95% CI 1.17-1.36) or 72 hours or less (night: adjusted OR 1.29, 95% CI 1.22-1.37, weekday: adjusted OR 1.05, 95% CI 1.01-1.10). Among stays lasting less than 24 hours and 24-72 hours, intravenously administered medications were ordered for 2788 (65.7%) and 10 722 (79.8%) patients, respectively, and computed tomography scans were performed for 1561 (36.8%) and 5354 (39.1%) patients, respectively.

interpretationShort general internal medicine hospital stays were common and were associated with patient, physician and situational factors. Interventions to avert hospital admission or reduce length of stay may be more effective if they are accessible outside typical working hours and provide access to intravenous therapy and radiological investigations.

Identifiers

PMID30692151
PMCPMC6349563

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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.