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Success Factors and Best Practices for Medical Travel Facilitators: Tips for Benchmarking And Startups
Published in Frederick J. DeMicco, Ali A. Poorani, Medical Travel Brand Management, 2023
We uncovered that there is a large variation in the length of stay among patients. Some trips lasting only three days and some as long as a month. Many include at least some leisurely activities outside of the realm of a hospital stay.
Assessment of Co-occurring Disorders, Levels of Care, and ASAM Requirements
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Elizabeth Reyes-Fournier, Tara G. Matthews, Tom Alexander
Low-intensity residential treatment is the initial and lowest level of residential services. Low-intensity residential treatment is provided in a setting that offers 24-hour care. The ASAM criteria specifically call for an emphasis on community re-entry in the low-intensity residential treatment environment. Throughout treatment at this level of care, ASAM calls for the availability of health-care staff who are appropriately trained and a minimum of five hours of treatment during a week of residential services (Ries et al., 2014). Despite calling for only five hours of clinical treatment per week, residential services offer overall structure, which is often much needed for individuals who have co-occurring disorders. Persons with co-occurring disorders and persons with substance use disorder only can receive treatment services from low-intensity residential. Length of stay is often guided by treatment progress or regression, combined with input from managed-care organizations or other external payer sources and stakeholders (Ries et al., 2014).
The fog of war and data
Published in Edward M. Rafalski, Ross M. Mullner, Healthcare Analytics, 2022
Edward M. Rafalski, Robert Marksthaler
The clinical opinion by many was that a significant portion of critical COVID-19 patients would develop pneumonia which would lead to intensive care unit (ICU) bed utilization, isolation room (rooms with negative air flow pressure) utilization and ventilator (vent) utilization.3,4 Applying this logic, the United States already had data from various sources that could be used to begin modeling inpatient bed demand. Central to bed demand modeling was the creation of length of stay (LOS) modeling assumptions for COVID-19 patients with pneumonia. Length of stay is a hospital operating statistic reflecting the number of days between admission and discharge in which a patient occupies a bed. These patients would place a strain on existing ICU, isolation bed and vent capacity. For example, three quarters of inpatients hospitalized for pneumonia (74.2%) do not have an ICU stay. Pneumonia inpatient hospitalizations resulting in acute care (short-term care received in a hospital, typically on a medical/surgical unit) instead of an ICU stay have an average length of stay (ALOS) of 4.2 days. If the inpatient hospitalization included time in the ICU, the average LOS increased to 7.2 days.5
Inpatient rehabilitation wheelchair management quality improvement project: Implications for patients with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2023
Sally M. Taylor, Laura Slowinske, Michael Dennison, Colton Manusky, Shawn Tan, Kinjal Patel, David Brewington
When an individual experiences a spinal cord injury (SCI), an alternative type of locomotion is typically required due to a change in functional status resulting from their injury. As of 2019, there are around 17,730 new cases of SCI in the United States each year.1 On average, these patients have a rehabilitation length of stay of 31 days.1 During the inpatient rehabilitation stay, a patient borrows a wheelchair (WC) that is the property of the facility to enable the patient to participate in a comprehensive rehabilitation program. The number and model of WCs in the fleet will vary from hospital to hospital. Inpatient fleet WC delivery timeframe is an important variable in the workflow of a rehabilitation hospital. During an inpatient rehabilitation stay, the Centers for Medicare & Medicaid Services requires patients to have 3 h of therapy per day at least 5 days per week; or at least 15 h of intensive rehabilitation therapy within a 7-consecutive day period.2 This enables the patient to engage in their multidisciplinary therapy sessions provided by a physical therapist (PT), occupational therapist (OT), speech-language pathologist, or prosthetist/orthotist.2
Visual estimation of blood loss versus quantitative blood loss for maternal outcomes related to obstetrical hemorrhage
Published in Baylor University Medical Center Proceedings, 2023
Michael Ayala, Vikas Nookala, Joshua Fogel, Mary Fatehi
Our study identified a statistically significant decrease in length of stay in patients in the QBL group vs the EBL group. The average length of stay in the EBL group was 3.2 days vs 2.6 days for the QBL group (P < 0.001). We are not aware of any previous comparisons of QBL vs EBL regarding length of stay. For studied clinical outcomes, past research reports no difference in rate of transfusions or maternal morbidity when using QBL.2 We suggest that our finding for lower length of stay may result from clinical reassurance afforded by using the more objective QBL. A lower QBL facilitates earlier discharge since it reduces the need for prolonged observation typically used with the more subjective EBL. Also, increased length of stay is associated with increased hospital costs and risk of complications, such as nosocomial infections and postdelivery venous thromboembolism and its related events.17 It is possible that a shorter length of stay by using QBL may reduce the rate of complications related to a longer length of stay.
How does a diagnosis of PTSD add to resource utilization in Florida emergency rooms?
Published in International Journal of Mental Health, 2023
Etienne E. Pracht, Kathleen C. Pracht, Barbara Langland-Orban, Natasha Kurji, Abraham Salinas
Despite these limitations, the analysis adds to our understanding of the costs associated with PTSD. Although we found no significant increase in healthcare cost, the increased time for patient care is an important factor. Improving and reducing length of stay (LOS) improves financial, operational, and clinical outcomes by decreasing the costs of care for a patient. Healthcare costs in this study only accounts for hospital-level cost but does not include overall cost for a patient (e.g., loss of productivity, out of pocket costs, other). The results also point to substantial variation across demographic characteristics, insurance type and status, the presence of existing comorbidities, and the types of treatment facilities, implying potential opportunities for improvement. From a public health perspective, it suggests there may be important areas of variation in clinical care as well as institutional practices, which, if shared, could lead to better treatment of PTSD. Unfortunately, a more detailed analysis of these areas of variation is beyond the scope of this study. The significant increase in ED visit time suggests, at the minimum, increased utilization of ED resources, for example bed space. The results also point to a need for further investigation concerning the differences, both concerning visit time and cost, based on insurance and facility type. With better understanding of the factors associated with treatment of PTSD, providers may be able to more efficiently treat affected patients.