Background: The underlying burden of medical co-morbidity is often the main driver of ICU transfer of patients initially admitted to the medical wards (1). The role of non-patient related factors is unclear, as are the mortality and economic data associated with ICU transfer from the medical ward. The purpose of this analysis was to identify [...]

Background: Migraine headache is a common pediatric disorder frequently leading to hospital admission. Inpatient migraine headache treatment involves increasingly complex treatments, including fluid resuscitation and a variety of medications and therapies. Our previous study(1) has shown that the cost of inpatient treatment for pediatric migraine headache is increasing at a higher rate than reported overall [...]

Background: Length of stay (LOS) is an important outcome measure in the evaluation of the quality of care for hospitalized patients. LOS in adults with diabetic ketoacidosis (DKA) is reported to be about 3 days, but detailed information about LOS in pediatric patients with DKA is lacking. Knowledge of factors that impact LOS is essential [...]

Background: Many hospitals have focused on discharging patients before noon as a goal to improve throughput and decrease length of stay. However, those patients who can be discharged early in the day may actually represent a loss and not a win for the system, as they could have potentially been discharged the evening before. Methods: [...]

Background: It has been recently shown that patients admitted at night and during the weekend have worse mortality outcomes. The impact of those variables on other important outcomes such as length of stay (LOS) and readmission is less clear. We sought to analyze this relationship in a large cohort of inpatients. Methods: We performed a [...]

Background: In 2012, as part of Value based purchasing program, CMS instituted the Hospital Readmission Reduction program (HRRP). This aimed to decrease the number of unplanned readmission to the hospital for six conditions: Acute myocardial infarction(AMI),chronic obstructive pulmonary disease( COPD), Heart Failure (HF), Pneumonia ( PNA) , Coronary bypass graft(CABG), Elective total hip arthroplasty (THA) [...]

Background: Readmission and length of stay are two hospital level metrics commonly used to assess the performance of hospitalist groups. Health care systems implement strategies aimed at reducing both. It is possible however that tactics aimed at improving one measure in individual patients may adversely impact the other. Studies in focused populations of patients hospitalized [...]

Background: Delirium is a neuropsychiatric syndrome that can occur in hospitalized patients. The negative impact that delirium has on the patient and the health system are well described and include increased mortality, risk of falls, length of stay and overall healthcare utilization. Delirium can have a heterogenous presentation including hyperactivity with agitation, restlessness and psychosis [...]

Background: Sickle cell disease (SCD) and its vasoocclusive sequela are significant causes of morbidity and mortality as well as acute care utilization throughout the United States, with an estimated 92,880 hospital admissions totaling $759 million in aggregate annual costs in 2014. There is a need within health care systems to identify strategies for achieving higher [...]

Background: Many hospitals set targets for discharging patients before noon in efforts to optimize patient throughput. However, discharge before noon (DCBN) has been associated with increased length of stay (LOS) in an adult population. The relationship between discharge time of day and LOS in pediatric patients is uncertain. This study aims to evaluate the relationship [...]