Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California

Article Abstract:

It is becoming increasingly important to examine regional and time factors so that medical care can be evaluated. Insurance companies and ambulatory surgical centers have increased the scrutiny of various practices. There are regional differences in hospitalization and surgery rates that cannot be explained by health or patient populations. Northeasterners are likely to be hospitalized for longer periods than people living on the West Coast, for example. These differences were investigated at six hospitals in Massachusetts and six in California to determine whether length of stay was related to how well the patient did after discharge. Six conditions were included for study: heart attack (acute myocardial infarction, or AMI), coronary artery bypass surgery (CABG), gallbladder removal (CHOLE, cholecystectomy), total hip replacement (THR), and transurethral prostatectomy (TURP, removal of the prostate). A total of 2,484 patients were surveyed at three months and again at twelve months after hospitalization. No consistent regional differences in length of stay were found, except for heart attack patients, who were hospitalized longer on the East Coast. There were significant differences in length of hospitalization between hospitals, and these differences did not produce any differences in the subsequent health of the patients. There were two exceptions: patients who underwent CABG and CHOLE who stayed in the hospital longer had less improvement in functional status. Patient satisfaction was not related to the amount of time spent in the hospital. Reductions in time spent in the hospital may thus be possible without adverse consequences for the patients, and in some cases, may improve well-being. The institutional and medical reasons for longer stays need to be identified. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical care, Demographic aspects, Hospital utilization, Hospital stays

---

Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes

Article Abstract:

A conceptual model of health-related quality of life (HRQL) may illustrate the interrelationships between different types of health outcome measures. The HRQL conceptual model or classification scheme integrates the clinicians' 'biomedical model' with the social scientists' 'quality of life model' to characterize five critical health outcome measures and their causal relationships. Health outcome measures exist on a continuum of increasing complexity. From the beginning end of the scale to the complex end, these measures are biological and physiological variables, symptoms, functional status, general health perceptions, and overall quality of life. Social, psychological, and biological complexity increase as the measures extend outward from the cellular level to the individual to the individual's interactions with society. Individual characteristics and environmental factors act on several measures of health outcome.

Models, Quality of life, Health status indicators

---

Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians: A Randomized Trial

Article Abstract:

Nurse practitioners may deliver the same level of care as a primary care physician. Researchers randomly assigned 1,316 patients to see a primary care physician or a nurse practitioner. No significant differences in health care outcome was seen between the two groups six months or one year after the visit. Patients who saw the nurse practitioner were generally as satisfied with the care they received as those who saw a primary care physician.

Evaluation, Nurse practitioners, Patient satisfaction

Similar abstracts:

• Abstracts: Preparations for skin conditions. Choosing wound dressings. Nurse prescribing - the knowledge base: What knowledge is needed for nurse prescribing?
• Abstracts: Shopping around for hospital services: a comparison of the United States and Canada. Mortality among patients admitted to hospitals on weekends as compared with weekdays
• Abstracts: Views of managed care: a survey of students, residents, faculty, and deans at medical schools in the United States
• Abstracts: Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Epidemiology of osteoporotic ankle fractures in elderly persons in Finland
• Abstracts: Management of severe ulcer rebleeding. The role of endoscopy in managing acute lower gastrointestinal bleeding

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.