OBJECTIVE To examine the effectiveness of Integrated Care and Discharge Support for elderly patients in reducing accident and emergency department attendance, acute hospital admissions, and hospital bed days after discharge. Factors that compromise its effectiveness were investigated and cost analysis was performed. DESIGN Cohort prospective study. SETTING Integrated Care and Discharge Supp...

BACKGROUND Investigation into the provider volume-outcomes association for patients undergoing spine surgery has been limited. OBJECTIVE To examine the impact of surgeon and hospital volume on the outcomes after decompression with or without fusion for lumbar spinal stenosis. METHODS Data from the Nationwide Inpatient Sample (2005-2008) were retrospectively extracted. Multivariate logistic ...

BACKGROUND In the U.S. small-area health services research studies are often based on the hospital service areas (HSAs) defined by the Dartmouth Atlas of Healthcare project. These areas are based on the geographic origins of Medicare Part A hospital patients, the great majority of whom are seniors. It is reasonable to question whether the geographic system so defined is appropriate for health s...

BACKGROUND Electrophysiological studies of the heart became commonplace in the past decade. Like cardiac catheterizations, electrophysiological studies are often considered "same day" procedures; patients are admitted in the morning, undergo the procedure, recover for several hours while confined to bed, and then are discharged from the hospital. The requisite time in bed varies widely between ...

BACKGROUND Bed alarm systems intended to prevent hospital falls have not been formally evaluated. OBJECTIVE To investigate whether an intervention aimed at increasing bed alarm use decreases hospital falls and related events. DESIGN Pair-matched, cluster randomized trial over 18 months. Nursing units were allocated by computer-generated randomization on the basis of baseline fall rates. Pat...

OBJECTIVES The Emilia-Romagna region of Italy has reduced the number of available hospital beds and introduced financial incentives to curb hospital use. The goal of this study was to assess the impact of these policies on changes over time in the number of acute hospital admissions classified in diagnosis related groups (DRGs) that could be treated safely and effectively in alternative, less c...

BACKGROUND The belief that many delays in discharge from hospital were caused by social service departments (SSDs) led to the Community Care Act 2003 giving NHS hospitals in England the power to charge SSDs. METHODS We surveyed 150 SSDs in England about the implementation of the Act and used routine data to analyse trends in the number of delayed discharge patients; the number and cause of de...

Introduction / objectives One of major threatening of search and destroy of MRSA is rising mupirocin resistance. In a 2,200-bed tertiary care hospital, only 38-bed neonatal intensive care unit (NICU) was under active surveillance and decolonization of MRSA colonizers for last 10 years. Mupirocin resistances of MRSA surveillance isolates from NICU and clinical isolates of Staphylococcus aureus f...

Background: Hospitals, the main providers of healthcare services, are costly centers which account for about 80% of the health sector budget and have a huge share of resources. Objective: This study aimed to analyze the economic performance of selected military hospitals in Tehran using hospital indicators and inpatient bed-day costs. Method...