Acute hospitalizations and outcomes in Veterans Affairs Hospitals 2011 to 2017

被引：0

作者：

Yoon, Jean ^{[1
,2
,3
]}

Phibbs, Ciaran S. ^{[1
,2
,4
,5
]}

Ong, Michael K. ^{[6
,7
,8
]}

Vanneman, Megan E. ^{[9
,10
,11
]}

Kizer, Kenneth W. ^{[12
]}

Chow, Adam ^{[1
]}

Redd, Andrew ^{[9
,10
]}

Jiang, Hao ^{[1
]}

Zhang, Yue ^{[9
,10
]}

机构：

[1] VA Palo Alto Hlth Care Syst, Hlth Econ Resource Ctr, 795 Willow Rd 152 MPD, Menlo Pk, CA 94025 USA

[2] VA Palo Alto Hlth Care Syst, Ctr Innovat Implementat, Menlo Pk, CA USA

[3] UCSF Sch Med, Dept Gen Internal Med, San Francisco, CA USA

[4] Stanford Univ, Sch Med, Dept Pediat, Stanford, CA USA

[5] Stanford Univ, Sch Med, Dept Hlth Policy, Stanford, CA USA

[6] VA Greater Angeles Healthcare Syst, VA Ctr Study Healthcare Innovat Implementat & Poli, Los Angeles, CA USA

[7] VA Greater Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA

[8] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA

[9] VA Salt Lake City Hlth Care Syst, Informat Decis Enhancement & Analyt Sci Ctr, Salt Lake City, UT USA

[10] Univ Utah, Sch Med, Dept Internal Med, Div Epidemiol, Salt Lake City, UT USA

[11] Univ Utah, Sch Med, Dept Populat Hlth Sci, Div Hlth Syst Innovat & Res, Salt Lake City, UT USA

[12] Stanford Univ, Sch Med Pulm & Crit Care Med, Stanford, CA USA

来源：

MEDICINE | 2024年 / 103卷 / 30期

关键词：

hospital; inpatient; mortality; Veterans; LENGTH-OF-STAY; READMISSION RATES; MORTALITY-RATES; QUALITY; TRENDS; CARE; PROGRAM;

D O I：

10.1097/MD.0000000000038934

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Hospitals within the Veterans Affairs (VA) health care system exhibited growing use of observation care. It is unknown how this affected VA hospital performance since observation care is not included in acute inpatient measures. To examine changes in VA hospitalization outcomes and whether it was affected by shifting acute inpatient care to observation care. Longitudinal analysis of 986,355 acute hospitalizations and observation stays in 11 states 2011 to 2017. We estimated temporal changes in 30-day mortality, 30-day readmissions, costs, and length of stay (LOS) for all hospitalizations and 6 conditions in adjusted models. Changes in mortality and readmissions were compared including and excluding observation care. A 9% drop in acute hospitalizations was offset by a 157% increase in observation stays 2011 to 2017. A 30-day mortality decreased but readmissions did not when observation stays were included (all P < .05). Mean costs increased modestly; mean LOS was unchanged. There were differences by condition. VA hospital mortality decreased; there was no change in readmissions.

引用

页数：8

共 37 条

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