Document Detail


Effects of end-of-month admission on length of stay and quality of care among inpatients with myocardial infarction.
MedLine Citation:
PMID:  12361814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We studied whether transfer of care when house staff and faculty switch services affects length of stay or quality of care among hospitalized patients. SUBJECTS AND METHODS: We performed a retrospective analysis in 976 consecutive patients admitted with myocardial infarction from 1995 to 1998. Patients who were admitted within 3 days of change in staff were denoted end-of-month patients. RESULTS: Of 782 eligible patients, 690 (88%) were admitted midmonth and 92 (12%) at the end of the month. The median length of stay was 7 days for midmonth and 8 days for end-of-month patients (P = 0.06). End-of-month admission was an independent predictor of length of stay in multivariate models. In addition, a significant difference in length of stay was noted between patients admitted at the beginning and end of the academic year. There were no statistically significant differences in the use of aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, or lipid-lowering agents at discharge between midmonth and end-of-month patients. Mortality and in-hospital adverse events did not differ between the two groups, with the possible exception of a greater incidence of acute renal failure in the end-of-month patients. CONCLUSIONS: Although admission during the last 3 days of the month is an independent predictor of length of stay, it does not have a large effect on quality of care among patients with myocardial infarction.
Authors:
James P Smith; Rajendra H Mehta; Sugata K Das; Thomas Tsai; Dean J Karavite; Pamela L Russman; David Bruckman; Kim A Eagle
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  113     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-10-03     Completed Date:  2002-10-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  288-93     Citation Subset:  AIM; IM    
Affiliation:
University of Michigan Heart Care Program, Ann Arbor, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiology Service, Hospital / manpower*,  standards
Continuity of Patient Care / organization & administration*
Coronary Care Units / manpower*,  standards
Female
Hospitals, University / manpower,  organization & administration,  utilization
Humans
Internship and Residency / manpower*
Length of Stay / statistics & numerical data*
Male
Medical Records
Medical Staff, Hospital / supply & distribution*
Michigan
Middle Aged
Myocardial Infarction / mortality,  rehabilitation*
Patient Admission / statistics & numerical data*
Quality of Health Care / statistics & numerical data*
Regression Analysis
Retrospective Studies
Time Factors
Workload

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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