TITLE:
Identification of At-Risk Inpatient Hospital Populations at the Community Level
AUTHORS:
Ronald Lagoe, Ruthie Lagoe
KEYWORDS:
Hospitalization, Hospital Lengths of Stay, Hospital Readmissions, Hospital Complications
JOURNAL NAME:
Open Journal of Nursing,
Vol.4 No.9,
August
6,
2014
ABSTRACT: This study focused
on hospital populations which account for large amounts of health care utilization
at the community level in the metropolitan area of Syracuse, New York. It
demonstrated that, between the two largest hospital inpatient services, adult
medicine patients accounted for a larger number of excess hospital patient days
than adult surgery over a two-year period. Adult medicine stays increased while
adult surgery stays declined. Adult medicine also accounted for a larger number
of excess inpatient days, an average daily census of 52.7 patients in 2013,
although adult medicine outliers comprised only 2.4 - 2.5 percent of discharges
while adult surgery patients comprised 4.4 - 4.5 percent of discharges for
these services. Adult medicine readmissions accounted for 79 - 81 percent of
these adverse events for the combined hospital during the two-year period.
Adult medicine complications accounted for 60 - 62 percent of complications in
the two hospitals for which data were available. These data clearly demonstrate
the challenges that adult medicine patients carry for providers as they attempt
to improve the efficiency and outcomes of care in local communities. In the
United States, payer reimbursement for the care of these patients frequently
does not match the resources required as funding emphasizes surgical
specialties and healthier patients. In metropolitan areas such as Syracuse,
where local populations are aging or declining, the expenses of caring for
these patients can become a major challenge for community providers.