Evidence map›Paper›PMID 36477564›Full record

Observational studyInternational journal for quality in health care : journal of the International Society for Quality in Health Care2023

Discharge to post-acute care and other predictors of prolonged length of stay during the initial COVID-19 surge: a single site analysis.

Jessica C O'neil, Benjamin P Geisler, Donna Rusinak, Ingrid V Bassett, Virginia A Triant, Rachael Mckenzie, Melissa L Mattison, Amy W Baughman

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal for quality in health care : journal of the International Society for Quality in Health Care, 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

8 authors.

Jessica C O'neilDepartment of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Benjamin P GeislerDepartment of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Donna RusinakPerformance Analysis and Improvement, Massachusetts General Hospital, 125 Nashua Street, Boston, MA 02114, USA.
Ingrid V BassettDepartment of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Virginia A TriantDepartment of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Rachael MckenzieDepartment of Case Management, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Melissa L MattisonDepartment of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Amy W BaughmanDepartment of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.ORCID 0000-0002-1275-3769

Funding

Development and application of a new simulation model for COVID-19R01AI042006 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI Kenneth Alan Freedberg, Anne Neilan · 1998 to 2026
$12.9M
Mentoring in patient-oriented research on HIV prevention in the US and South AfricaK24AI141036 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI Ingrid Valerie Bassett · 2019 to 2026
$1.1M
NIAID NIH HHS K24 AI141036NIAID NIH HHS R01 AI042006NIH HHS K24AI141036NIH HHS R01 AI042006-24S1Weissman Family MGH Scholar Award R01 AI042006-24S1Winickoff Scholars Program
6 · The paper itself

Abstract

backgroundDuring the initial surge of coronavirus disease 2019 (COVID-19), health-care utilization fluctuated dramatically, straining acute hospital capacity across the USA and potentially contributing to excess mortality.

methodsThis was an observational retrospective study of patients with COVID-19 admitted to a large US urban academic medical center during a 12-week COVID-19 surge in the Spring of 2020. We describe patterns in length of stay (LOS) over time. Our outcome of interest was prolonged LOS (PLOS), which we defined as 7 or more days. We performed univariate analyses of patient characteristics, clinical outcomes and discharge disposition to evaluate the association of each variable with PLOS and developed a final multivariate model via backward elimination, wherein all variables with a P-value above 0.05 were eliminated in a stepwise fashion.

resultsThe cohort included 1366 patients, of whom 13% died and 29% were readmitted within 30 days. The LOS (mean: 12.6) fell over time (P < 0.0001). Predictors of PLOS included discharge to a post-acute care (PAC) facility (odds ratio [OR]: 11.9, 95% confidence interval [CI] 2.6-54.0), uninsured status (OR 3.2, CI 1.1-9.1) and requiring intensive care and intubation (OR 18.4, CI 11.5-29.6). Patients had a higher readmission rate if discharged to PAC facilities (40%) or home with home health agency (HHA) services (38%) as compared to patients discharged home without HHA services (26%) (P < 0.0001).

conclusionPatients hospitalized with COVID-19 during a US COVID-19 surge had a PLOS and high readmission rate. Lack of insurance, an intensive care unit stay and a decision to discharge to a PAC facility were associated with a PLOS. Efforts to decrease LOS and optimize hospital capacity during COVID-19 surges may benefit from focusing on increasing PAC and HHA capacity and resources.

Indexed as

COVID-19Patient DischargeHumansLength of StayPatient ReadmissionRetrospective StudiesRisk FactorsSubacute Carebed capacityCOVID-19length of staypost–acute carereadmissions

Identifiers

PMID36477564
PMCPMC9806864

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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.