Arch Intern Med
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Multicenter Study
Trends in postdischarge mortality and readmissions: has length of stay declined too far?
Length of hospital stay continues to decline, but the effect on postdischarge outcomes is unclear. ⋯ The dramatic decline in length of stay from 1991 through 1997 was not associated with worse postdischarge outcomes for patients without DNR orders. However, postdischarge mortality increased among patients with early DNR orders, and some of this trend may be due to patients being discharged more rapidly than previously.
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Multicenter Study
Adverse events due to discontinuations in drug use and dose changes in patients transferred between acute and long-term care facilities.
Care transitions are commonplace for ill older adults, but no studies to our knowledge have examined the occurrence of iatrogenic harm from medication changes during patient transfer. ⋯ Medication changes are common during transfer between hospital and nursing home and are a cause of ADEs. Research is needed on interinstitutional patient care and systems interventions designed to prevent ADEs.