Journal of hospital medicine : an official publication of the Society of Hospital Medicine
-
Acute Care for Elders (ACE) programs improve outcomes for older adults; however, little is known about whether impact varies with comorbidity severity. ⋯ The greatest reductions in cost and LOS were in patients with greater comorbidity scores. Risk stratification may help hospitals prioritize admissions to ACE units to maximize the impact of the more intensive intervention.
-
A small proportion of patients accounts for a large proportion of hospitalizations. ⋯ Emergent themes pointed to factors which influence patients' onset of high hospital use, fluctuations in their illness over time, and triggers to seek care during an episode of illness. These findings enable patients' perspectives to be incorporated into the design of programs serving similar populations of frequently hospitalized patients.
-
Most inpatient care for children occurs outside tertiary children's hospitals, yet these facilities often dictate quality metrics. Our objective was to calculate the mean readmission rates and the Achievable Benchmarks of Care (ABCs) for pediatric diagnoses by different hospital types: metropolitan teaching, metropolitan nonteaching, and nonmetropolitan hospitals. ⋯ ABCs based on hospital type may serve as a better metric to explain case-mix variation among different hospital types in pediatric inpatient care. The mean rates and ABCs for SCD and mental health disorders were much higher and with more outlier hospitals, which indicate high-value targets for quality improvement.