Evidence map›Paper›PMID 35072897›Full record

ArticleHEC forum : an interdisciplinary journal on hospitals' ethical and legal issues2023

Guardianship Before and Following Hospitalization.

Jennifer Moye, Andrew B Cohen, Kelly Stolzmann, Elizabeth J Auguste, Casey C Catlin, Zachary S Sager, Rachel E Weiskittle, Cindy B Woolverton, Heather L Connors, Jennifer L Sullivan

Abstract read
In one paragraph

Article in HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

10 authors.

Jennifer MoyeVA New England Geriatric Research Education and Clinical Center (GRECC), Boston, MA, USA. Jennifer.moye@va.gov.ORCID http://orcid.org/0000-0002-3434-347X
Andrew B CohenVA Connecticut Healthcare System, West Haven, CT, USA.
Kelly StolzmannVA Boston Healthcare System, 150 South Huntington, Jamaica Plain, MA, 02130, USA.
Elizabeth J AugusteVA New England Geriatric Research Education and Clinical Center (GRECC), Boston, MA, USA.
Casey C CatlinVA Boston Healthcare System, 150 South Huntington, Jamaica Plain, MA, 02130, USA.
Zachary S SagerVA New England Geriatric Research Education and Clinical Center (GRECC), Boston, MA, USA.
Rachel E WeiskittleVA New England Geriatric Research Education and Clinical Center (GRECC), Boston, MA, USA.
Cindy B WoolvertonVA Boston Healthcare System, 150 South Huntington, Jamaica Plain, MA, 02130, USA.
Heather L ConnorsGuardian Community Trust, Andover, MA, USA.
Jennifer L SullivanVA Boston Healthcare System, 150 South Huntington, Jamaica Plain, MA, 02130, USA.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Intramural VA VA999999NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p < .001). Length of stay was lower following guardianship appointment (11.65, SD = 12.02, t = 15.16, p < .001); while higher than the comparison group (M = 7.60, SD = 8.46), differences were not associated with guardianship status. In a separate analysis involving 35 individuals who were hospitalized both prior to and following guardianship, length of stay was longer in the year prior (M = 23.00, SD = 37.55) versus after guardianship (M = 10.37, SD = 10.89, F = 4.35, p = .045). In qualitative analyses, four themes associated with lengths of stay exceeding 45 days prior to guardianship appointment were: administrative issues, family conflict, neuropsychiatric comorbidity, and medical complications. Our results suggest that persons who are admitted to hospitals, and subsequently require a guardian, experience extended lengths of stay for multiple complex reasons. Once a guardian has been appointed, however, differences in hospital lengths of stay between patients with and without guardians are reduced.

Indexed as

HospitalizationLegal GuardiansHumansRetrospective StudiesCapacityFamily conflictGuardianshipHospitalizationLength of stay

Identifiers

PMID35072897
PMCPMC10281591

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Registered trials

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