Benjamin Kalivas, Jingwen Zhang, Kristine Harper, Jennifer Dulin, Marc Heincelman, Justin Marsden, Kelly J Hunt, Patrick D Mauldin, William P Moran, Meghan K Thomas
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The Combined Effect of Delirium and Falls on Length of Stay and Discharge.
Introduction: Delirium or a fall are associated with many negative outcomes including increased length of stay (LOS) and discharge to a facility; however, this relationship is incompletely understood.
Methods: A cross-sectional study of all hospitalizations in a large, tertiary care hospital evaluated the effect of delirium and a fall on the outcomes of LOS and risk of being discharged to a facility.
Results: The study included 29,655 hospital admissions. A total of 3,707 (12.5%) patients screened positive for delirium and 286 (0.96%) had a reported fall. After adjustment for covariates, relative to patients without delirium or a fall, patients with delirium only had a 1.64-fold longer LOS; patients with fall only had a 1.96-fold longer LOS; and patients who had delirium and fall had a 2.84-fold longer LOS. The adjusted odds of discharge to a facility, relative to those without delirium or a fall, was 8.98 times higher in those with delirium and a fall.
Conclusions: Delirium and falls influence LOS and likelihood of being discharged to a facility. The joint impact of falls and delirium on LOS and facility discharge was more than additive. Hospitals should consider the integrated management of delirium and falls.
期刊介绍：
The Journal for Healthcare Quality (JHQ), a peer-reviewed journal, is an official publication of the National Association for Healthcare Quality. JHQ is a professional forum that continuously advances healthcare quality practice in diverse and changing environments, and is the first choice for creative and scientific solutions in the pursuit of healthcare quality. It has been selected for coverage in Thomson Reuter’s Science Citation Index Expanded, Social Sciences Citation Index®, and Current Contents®.
The Journal publishes scholarly articles that are targeted to leaders of all healthcare settings, leveraging applied research and producing practical, timely and impactful evidence in healthcare system transformation. The journal covers topics such as:
Quality Improvement • Patient Safety • Performance Measurement • Best Practices in Clinical and Operational Processes • Innovation • Leadership • Information Technology • Spreading Improvement • Sustaining Improvement • Cost Reduction • Payment Reform
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