Acute hospitalizations and outcomes in Veterans Affairs Hospitals 2011 to 2017-Reference-Cited by-同舟云学术

Acute hospitalizations and outcomes in Veterans Affairs Hospitals 2011 to 2017

Published:2024-07-26 Issue:30 Volume:103 Page:e38934
ISSN:0025-7974
Container-title:Medicine
language:en
Short-container-title:

Author:

Yoon Jean¹²³^ORCID,Phibbs Ciaran S.¹²⁴,Ong Michael K.⁵⁶⁷,Vanneman Megan E.⁸⁹¹⁰,Kizer Kenneth W.¹¹,Chow Adam¹,Redd Andrew⁸⁹,Jiang Hao¹,Zhang Yue⁸⁹

Affiliation:

1. Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, CA

2. Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA

3. Department of General Internal Medicine, UCSF School of Medicine, San Francisco, CA

4. Departments of Pediatrics and Health Policy, Stanford University School of Medicine, Stanford, CA

5. VA Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA

6. Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA

7. Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA

8. Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, UT

9. Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT

10. Department of Population Health Sciences, Division of Health System Innovation and Research, University of Utah School of Medicine, Salt Lake City, UT

11. Stanford University School of Medicine,Pulmonary and Critical Care Medicine, Stanford, CA.

Abstract

Hospitals within the Veterans Affairs (VA) health care system exhibited growing use of observation care. It is unknown how this affected VA hospital performance since observation care is not included in acute inpatient measures. To examine changes in VA hospitalization outcomes and whether it was affected by shifting acute inpatient care to observation care. Longitudinal analysis of 986,355 acute hospitalizations and observation stays in 11 states 2011 to 2017. We estimated temporal changes in 30-day mortality, 30-day readmissions, costs, and length of stay (LOS) for all hospitalizations and 6 conditions in adjusted models. Changes in mortality and readmissions were compared including and excluding observation care. A 9% drop in acute hospitalizations was offset by a 157% increase in observation stays 2011 to 2017. A 30-day mortality decreased but readmissions did not when observation stays were included (all P < .05). Mean costs increased modestly; mean LOS was unchanged. There were differences by condition. VA hospital mortality decreased; there was no change in readmissions.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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