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Medical Care Mar 2020Improving the collection and quality of race and ethnicity reported in hospital data is a key step in identifying disparities in health service utilization and outcomes...
BACKGROUND
Improving the collection and quality of race and ethnicity reported in hospital data is a key step in identifying disparities in health service utilization and outcomes and opportunities for quality improvement.
OBJECTIVE
The objective of this study was to assess the quality of race/ethnicity reported in hospital discharge data and examine the impact on the identification of disparities in select health outcomes in New York City.
RESEARCH DESIGN
Using the birth certificate as a gold standard, we examined the quality of hospital discharge race/ethnicity and estimated the impact of misclassification on racial/ethnic disparities in severe maternal morbidity and preventable hospitalizations.
SUBJECTS
Delivery hospitalizations from the New York State hospital discharge data (Statewide Planning and Research Cooperative System) linked with 2015 New York City birth certificates.
MEASURES
Sensitivity and positive predictive value (PPV).
RESULTS
The non-Hispanic white and black race had relatively high sensitivity and PPV. Hispanic ethnicity and Asian race had moderate sensitivity and high PPV, but were often misclassified as "Other." As a result, health disparities may be underestimated for those of Hispanic ethnicity and Asian race, particularly for indicators that use population denominators drawn from another source.
CONCLUSIONS
The quality of hospital discharge data varies by race/ethnicity and may underestimate disparities in some groups. Future research should validate findings with other data sources, identify driving factors, and evaluate progress over time.
Topics: Adult; Birth Certificates; Ethnicity; Female; Health Status Disparities; Humans; Male; New York City; Patient Discharge; Racial Groups
PubMed: 31851043
DOI: 10.1097/MLR.0000000000001259 -
Journal of Hospital Medicine Jun 2021
Topics: Cost-Benefit Analysis; Humans; Length of Stay; Patient Discharge; Time Factors
PubMed: 34129493
DOI: 10.12788/jhm.3613 -
The Journal of Nursing Administration Apr 2021Objectives were to evaluate patient perceptions of a nurse-led, patient-centered gratitude intervention and if nurses identified actionable items to improve patient's...
OBJECTIVE
Objectives were to evaluate patient perceptions of a nurse-led, patient-centered gratitude intervention and if nurses identified actionable items to improve patient's hospitalization experience.
BACKGROUND
Research demonstrates positive effects of gratitude and caring interventions on patient health and well-being. Evidence is sparse regarding nurse-led gratitude interventions improving hospitalized patient's experiences.
METHODS
In this pilot study, 91 adult medical patients completed gratitude forms twice daily for up to 6 shifts and a study discharge form documenting intervention perceptions. In response to the patients' gratitude-related feedback, RNs recorded patient experience-related actions they and interprofessional teams could implement.
RESULTS
On average, patients perceived the nurse-led gratitude intervention as helpful (4.2) (1 = very unhelpful, 5 = very helpful) and improved hospitalization experiences (4.3) (1 = seldom, 5 = never). Most of the time actions were required or to be taken, based on patient gratitude intervention responses.
CONCLUSIONS
Patient perceptions of nurse-led gratitude intervention demonstrated helpfulness and improved hospitalization experience.
Topics: Adult; Female; Humans; Male; Middle Aged; Nurse-Patient Relations; Patient Discharge; Patient Satisfaction; Patient-Centered Care; Pilot Projects; Spirituality; Workplace
PubMed: 33734178
DOI: 10.1097/NNA.0000000000000997 -
Health & Social Care in the Community Nov 2022Hospital discharge for people experiencing homelessness is a perennial challenge. The Homeless Reduction Act 2017 (HRA) places new responsibilities on hospitals, but it...
Homelessness, hospital discharge and challenges in the context of limited resources: A qualitative study of stakeholders' views on how to improve practice in a deprived setting.
Hospital discharge for people experiencing homelessness is a perennial challenge. The Homeless Reduction Act 2017 (HRA) places new responsibilities on hospitals, but it remains unknown whether this has affected discharge practices. This qualitative study explores stakeholders' views on the challenges around hospital discharge for people experiencing homelessness, in the context of a deprived English city. Semi-structured interviews were conducted with 27 stakeholders. Participants were purposively recruited from local authority, third sector and the National Health Service. Interviews were transcribed and thematic analysis conducted. Analysis generated three main themes. First, a need for better planning and communication with the third sector, particularly around medication, prescriptions and information sharing. Second, the need to improve awareness and 'upskill' hospital staff to work more effectively with people experiencing homelessness, including understanding their needs, the wider support available and HRA requirements. Third, there were calls for (re)investment in a different approach to better support this population, based on outreach and flexibility. The need for improved partnership working and investment was emphasised. Whilst recognising the challenges faced by hospitals, especially within the context of funding cuts, this study highlights the need to recognise the third sector's contribution in supporting people experiencing homelessness in the community. Developing site-specific checklists for practice before discharge (and as early as possible) may help to ensure appropriate measures are in place. Improving legal literacy in the context of what an appropriate discharge is for people experiencing homelessness may help develop staff confidence to challenge the focus on 'quick' discharges.
Topics: Humans; Patient Discharge; State Medicine; Ill-Housed Persons; Qualitative Research; Hospitals
PubMed: 35730970
DOI: 10.1111/hsc.13887 -
Journal of Advanced Nursing Jun 2020The purpose of this study was to validate patient's primary caregiver and their nurse's perception of patient discharge readiness assessment and their association with...
AIMS
The purpose of this study was to validate patient's primary caregiver and their nurse's perception of patient discharge readiness assessment and their association with postdischarge medical consumption.
DESIGN
The study employed a descriptive research, prospective longitudinal study design.
METHOD
The study was performed in a ward of a medical centre in Taipei, Taiwan, from June 2017-May 2018. Obtained data were analysed using an independent t test, one-way ANOVA and logistic regression approach.
RESULTS/FINDINGS
The number of comorbidities and the number of days of hospital stay were positively associated with post discharge emergency room visits. Caregiver readiness for hospital discharge had significant negative correlation with patient's 30-day readmission. Both caregiver and nurse readiness for the hospital discharge scale score were not factors associated with the patients' 30-day emergency room visit.
CONCLUSION
Based on the research findings, to assess the discharge readiness as perceived by caregivers at patients' discharge is recommended.
IMPACT
Caregiver and nurse scores on readiness for hospital discharge showed a significant positive correlation. The higher the score of a caregiver's readiness for a patient's hospital discharge, the lower the 30-day readmission rate. Family-centred care enables patients to safely pass though the transition phase from hospital to community and reduces the postrelease consumption of medical resources. The discharge readiness perceived by caregivers should be included in any decision-making.
Topics: Adult; Aftercare; Aged; Aged, 80 and over; Caregivers; Female; Guidelines as Topic; Humans; Male; Middle Aged; Nursing Staff, Hospital; Patient Acceptance of Health Care; Patient Discharge; Patient Readmission; Taiwan
PubMed: 32056269
DOI: 10.1111/jan.14329 -
Praxis Feb 2023Predictors for Early Unplanned Readmissions Unplanned rehospitalizations represent a major burden for patients, their relatives and the healthcare system. Since the...
Predictors for Early Unplanned Readmissions Unplanned rehospitalizations represent a major burden for patients, their relatives and the healthcare system. Since the introduction of the SwissDRG in 2012, financial incentives for hospitals have been promoted to forestall readmissions. Not every patient is at risk for rehospitalization. Affected patients can be identified by predictors from various areas in order to implement adequate interventions and avoid readmissions. Predictors can be directly related to patients as in the case of polypharmacy, multiple comorbidities or related to gender, but also provider-related and system-related. Early follow-up visits or a pre-discharge medication review are cited as effective interventions.
Topics: Humans; Patient Readmission; Patient Discharge
PubMed: 36722109
DOI: 10.1024/1661-8157/a003992 -
Zeitschrift Fur Gerontologie Und... Dec 2022
Topics: Humans; Patient Discharge; Hospitals
PubMed: 36355072
DOI: 10.1007/s00391-022-02136-1 -
Surgery Jan 2020
Topics: Humans; Patient Discharge; Patient Readmission; Thyroid Gland
PubMed: 31582309
DOI: 10.1016/j.surg.2019.06.055 -
Surgery Oct 2019
Topics: Humans; Patient Discharge; Prognosis; Skilled Nursing Facilities
PubMed: 31326185
DOI: 10.1016/j.surg.2019.04.047 -
Clinical Gastroenterology and... Dec 2020
Topics: Hospitals; Humans; Inflammatory Bowel Diseases; Patient Discharge; Venous Thromboembolism
PubMed: 33190747
DOI: 10.1016/j.cgh.2019.08.026