Evidence map›Paper›PMID 36973689›Full record

ArticleBMC health services research2023

Severity of illness and risk of mortality in Mayo Clinic's virtual hybrid advanced care at home program: a retrospective cohort study.

Margaret R Paulson, Ricardo A Torres-Guzman, Francisco R Avila, Karla C Maita, John P Garcia, Antonio J Forte, Gautam V Matcha, Ricardo J Pagan, Michael J Maniaci

Open access · goldFull text read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
5.7field-weighted citation impact, top 4% of its field
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

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Review
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  4. Review
  5. Patterns of Use of β-2 Agonists, Steroids, and Mucoactive Medications to Treat Bronchiolitis in the PICU: U.S. Pediatric Health Information System 2009-2022 Database Study.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025
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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

9 authors at 3 institutions in 1 country.

Margaret R PaulsonDivision of Hospital Internal Medicine, Mayo Clinic Health Systems, Eau Claire, WI, USA.
Ricardo A Torres-GuzmanDivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Francisco R AvilaDivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Karla C MaitaDivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA.
John P GarciaDivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Antonio J ForteDivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Gautam V MatchaDivision of Hospital Internal Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
Ricardo J PaganDivision of Hospital Internal Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
Michael J ManiaciDivision of Hospital Internal Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA. Maniaci.Michael@mayo.edu.
Mayo Clinic in Florida · USWinnMed · USMayo Clinic Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn July 2020, Mayo Clinic launched Advanced Care at Home (ACH), a high-acuity virtual hybrid hospital-at-home model (HaH) of care at Mayo Clinic Florida and Northwest Wisconsin, an urban destination medical center and a rural community practice respectively. This study aims to describe demographic characteristics of ACH patients as well as their acuity of illness using severity of illness (SOI) and risk of mortality (ROM), to illustrate the complexity of patients in the program, taking into account the different diagnostic related groups.

methodsMayo Clinic uses All Patient Refined-Diagnosis Related Groups (APR-DRG) to calculate SOI and ROM on hospitalized patients. APR-DRG data, including SOI and ROM, were gathered from individual chart reviews from July 6, 2020, to March 31, 2022.

resultsOut of 923 patients discharged from ACH, the average APR-DRG SOI was 2.89 (SD 0.81) and ROM was 2.73. (SD 0.92). Mean age was 70.88 (SD 14.46) years, 54.6% were male patients and the average length of stay was 4.10 days. The most frequent diagnosis was COVID-19 infection with 162 patients (17.6%), followed by heart failure exacerbation (12.7%) and septicemia (10.9%). The 30-day readmission rate after discharge from ACH was 11.2% (n = 103) and the 30-day mortality rate was 1.8% (n = 17). There were no in-program patient deaths.

conclusionsSOI and ROM from patients at the ACH program have been shown to be in the range of "moderate/major" according to the APR-DRG classification. The ACH program is capable of accepting and managing highly complex patients that require advanced therapeutic means. Furthermore, the ACH program has an in-program mortality rate of 0 to date. Therefore, ACH is rising as a capable alternative to the brick-and-mortar hospital.

Indexed as

COVID-19AgedFemaleHumansLength of StayMalePatient DischargePatient ReadmissionRetrospective StudiesSeverity of Illness IndexHome hospitalRisk of mortalitySeverity of illnessTelemedicine

Identifiers

PMID36973689
PMCPMC10041490
OpenAlexW4361005945

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LicenceCC BY
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Read underepoch 390

Registered trials

None linked

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.