Demographic and clinical characteristics of adult hospitalized patients with prolonged hospital stay
Keywords:
hospital administration, hospitalization time, cost-effectiveness analysis, insurance, misuse of health services, excessive use of health services, bed occupancy, quality management, hospital economics
Abstract
Introduction: Prolonged hospital stay is the time in days of hospitalization additional to that estimated according to the statistical parameters of each institution. It depends on multiple factors and may vary with the study time.
Objectives: To describe the demographic and clinical characteristics of adult patients with prolonged hospital stay admitted to a referral hospital in Asunción, Paraguay, in 2024.
Methodology: An observational, descriptive, cross-sectional design was applied including men and women, over 18 years of age, with a stay of more than 10 days in the Clinical Medicine service from March to October 2024. Data were extracted at discharge. Demographic and clinical variables and causes of prolonged stay were measured. Descriptive statistics were applied. The project was approved by the Ethics Committee of the Universidad Privada del Este, Asunción.
Results: Sixty-seven subjects entered the study: 43 males with a mean age of 70 ± 17 years and 23 females with a mean age of 65 ± 15 years. The median length of stay was 14 days (interquartile range 11 – 22 days). Stroke was the most frequent admission diagnosis (22.39%). Arterial hypertension was the prevalent comorbidity (91.04%). Many patients had various causes of prolonged stay. The most frequent were poor clinical condition (97.01%) and the need for prolonged treatment (88.06%). Mortality was observed in 3 cases (4.48%).
Conclusion: The most frequent causes of prolonged stay in the Clinical Medical service were conditions inherent to the clinical condition of the patients. These conditions could affect the administrative aspects of hospital management.
References
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14. Soffer S, Zimlichman E, Glicksberg BS, Efros O, Levin MA, Freeman R, et al. Obesity as a mortality risk factor in the medical ward: a case control study. BMC Endocr Disord [Internet]. 2022 [cited 2024 Mar 10];22(1):13. Available from: https://pubmed.ncbi.nlm.nih.gov/34991575/. doi: 10.1186/s12902-021-00912-5
15. Pinzón-Espitia O, Pardo-Oviedo JM, Ibáñez-Pinilla Ml. Detection of nutritional risk and hospital stay in the hospitalized elderly adult. Nutr Hosp [Internet]. 2021 [cited 2024 Mar 10];38(3):464–9. Available from: https://pubmed.ncbi.nlm.nih.gov/33887948/. doi: 10.20960/nh.03200
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19. Liu W, Shi J, He S, Luo X, Zhong W, Yang F. Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model. PLoS One [Internet]. 2021 [cited 2024 Feb 15];16(3): e0248157. Available from: https://pubmed.ncbi.nlm.nih.gov/33711043/. doi: 10.1371/journal.pone.0248157
20. Regassa LD, Tola A. Magnitude and predictors of hospital admission, readmission, and length of stay among patients with type 2 diabetes at public hospitals of Eastern Ethiopia: a retrospective cohort study. BMC Endocr Disord [Internet]. 2021 [cited 2024 Mar 10];21(1):74. Available from: https://pubmed.ncbi.nlm.nih.gov/33866969/.doi: 10.1186/s12902-021-00744-3
21. Reyes Sanamé FA, Pérez Alvares ML, Medina Arce MM, Navarro Caboverde Y, Fernández Mendoza A. Aspectos clínicos y epidemiológicos de pacientes ingresados por diabetes mellitus de tipo 2 en el hospital de Moa. Medisan [Internet]. 2020 [citado 3 Abr 2024];24(6):1143–56. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192020000601143&lang=es
22. Seringa J, Marques AP, Moita B, Gaspar C, Raposo JF, Santana R. The impact of diabetes on multiple avoidable admissions: A cross-sectional study. BMC Health Serv Res [Internet]. 2019 [cited 2024 Feb 15];19(1):1002. Available from: https://pubmed.ncbi.nlm.nih.gov/31881962/. doi: 10.1186/s12913-019-4840-4
23. Skinner HG, Coffey R, Jones J, Heslin KC, Moy E. The effects of multiple chronic conditions on hospitalization costs and utilization for ambulatory care sensitive conditions in the United States: A nationally representative cross-sectional study. BMC Health Serv Res [Internet]. 2016 [cited 2024 Mar 10];16:77. Available from: https://pubmed.ncbi.nlm.nih.gov/26926525/. doi: 10.1186/s12913-016-1304-y
24. Mejia ChR, Paucar-Tito L, Morales-Concha L, Atamari-Anahui N, Rondón-Abuhadba EA, Ordoñez-Linares ME. Asociación entre tiempo de hospitalización y pie diabético: estudio transversal analítico en tres hospitales peruanos. Medwave [Internet]. 2018 [citado 15 Feb 2024];18(7):e7336. Disponible en: https://www.medwave.cl/investigacion/estudios/7336.html
25. Yang L, Li M, Shu J, Yang Y, Huang Q. A risk prediction model for prolonged length of stay in patients with acute exacerbations of chronic obstructive pulmonary disease: A retrospective study of 225 patients in a single center in Kunming China. Med Sci Monit [Internet]. 2022 [cited 2024 Feb 15];28:e934392. Available from: https://pubmed.ncbi.nlm.nih.gov/35136009/. doi: 10.12659/MSM.934392
2. Arbeláez-Collazos L, Calvo-Betancourt L, Valencia-Mejía M, Juan M, Amaya N, Juan E, et al. Factores de riesgo asociados a estancia hospitalaria prolongada en pacientes con falla cardiaca aguda. Rev Colomb Cardiol [Internet]. 2021 [citado 15 Feb 2024];28(2):113–8. Disponible en: https://www.rccardiologia.com/files/rcc_21_28_2_113-118.pdf
3. Twersky SE, Davey A. National hospitalization trends and the role of preventable hospitalizations among centenarians in the United States (2000–2009). Int J Environ Res Public Health [Internet]. 2022 [cited 2024 Feb 15];19(2):795. Available from: https://pubmed.ncbi.nlm.nih.gov/35055617
4. Morera-Salas M. Índice de internación ajustado por riesgo en hospitales públicos de Costa Rica. Rev Gerenc Polít Salud [Internet]. 2016 [citado 15 Feb 2024];15(31):202–14. Disponible en: https://www.redalyc.org/pdf/545/54549363010.pdf
5. Sánchez Hernández E, Pérez Fouces FE, López Castillo EE, De la Torre Vega G, Velez Fernández G. Factores de riesgo asociados a estadía hospitalaria prolongada en pacientes adultos. Medisan [Internet]. 2019 [citado 15 Feb 2024];23(2):271–82. Disponible en: https://medisan.sld.cu/index.php/san/article/view/2194/pdf
6. Ceballos-Acevedo TM, Velásquez-Restrepo PA, Jaén-Posada JS. Duración de la estancia hospitalaria. Metodologías para su intervención. Rev Gerenc Polít Salud [Internet]. 2014 [citado 3 Apr 2024];13(27):274–95. Disponible en: https://revistas.javeriana.edu.co/index.php/gerepolsal/article/view/11972/9805. doi: http://dx.doi.org/10.11144/Javeriana.rgyps13-27.dehm
7. Ghosh AK, Geisler BP, Ibrahim S. Racial/ethnic and socioeconomic variations in hospital length of stay: A state-based analysis. Medicine (Baltimore) [Internet]. 2021 [cited 2024 Feb 15]; 100(20): e25976. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8137046/. doi: 10.1097/MD.0000000000025976
8. Cai Y, Lo JJM, Venkatachalam I, Kwa AL, Tambyah PA, Hsu LY, et al. The impact of healthcare associated infections on mortality and length of stay in Singapore - A time-varying analysis. Infect Control Hosp Epidemiol. 2020;41(11):1315–20
9. Huang Ch. Clinical analysis and management of long-stay patients. Int J Gen Med [Internet]. 2021 [cited 2024 Apr 3]; 14:2351–7. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8187092/. doi: 10.2147/IJGM.S310217
10. Díaz-Koo CJ, Fernández-Mogollón J, Nakayama CH. Características de los pacientes con estancia prolongada en el servicio de cirugía general del Hospital Nacional Almanzor Aguinaga Asenjo. Rev Cuerpo Med HNAAA [Internet]. 2020 [citado 3 Apr 2024];13(3):251–6. Disponible en: http://www.scielo.org.pe/pdf/rcmhnaaa/v13n3/2227-4731-rcmhnaaa-13-03-251.pdf. doi: https://doi.org/10.35434/rcmhnaaa.2020.133.732
11. Ghosh AK, Unruh MA, Soroka O, Shapiro M. Trends in medical and surgical admission length of stay by race/ethnicity and socioeconomic status: A time series analysis. Health Serv Res Manag Epidemiol [Internet]. 2021 [cited 2024 Feb 15]; 8:23333928211035581. Available from: https://pubmed.ncbi.nlm.nih.gov/34377740/. doi: 10.1177/23333928211035581
12. Siddique SM, Tipton K, Leas B, Greysen SR, Mull NK, Lane-Fall M, et al. Interventions to reduce hospital length of stay in high-risk populations: A systematic review. JAMA Netw Open [Internet]. 2021 [cited 2024 Feb 20];4(9): e2125846. Available from: https://pubmed.ncbi.nlm.nih.gov/34542615/. doi: 10.1001/jamanetworkopen.2021.25846
13. Kojimahara N, Hoshi K, Tatemichi M, Toyota A. The relationship of hospital stay and readmission with employment status. Ind Health [Internet]. 2021 [cited 2024 Feb 20];59(1):18–26. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7855672/. doi: 10.2486/indhealth.2020-0104
14. Soffer S, Zimlichman E, Glicksberg BS, Efros O, Levin MA, Freeman R, et al. Obesity as a mortality risk factor in the medical ward: a case control study. BMC Endocr Disord [Internet]. 2022 [cited 2024 Mar 10];22(1):13. Available from: https://pubmed.ncbi.nlm.nih.gov/34991575/. doi: 10.1186/s12902-021-00912-5
15. Pinzón-Espitia O, Pardo-Oviedo JM, Ibáñez-Pinilla Ml. Detection of nutritional risk and hospital stay in the hospitalized elderly adult. Nutr Hosp [Internet]. 2021 [cited 2024 Mar 10];38(3):464–9. Available from: https://pubmed.ncbi.nlm.nih.gov/33887948/. doi: 10.20960/nh.03200
16. Guerra RS, Fonseca I, Pichel F, Restivo MT, Amaral TF. Usefulness of six diagnostic and screening measures for undernutrition in predicting length of hospital stay: A comparative analysis. J Acad Nutr Diet [Internet]. 2015 [cited 2024 Mar 10];115(6):927–38. Available from: https://www.jandonline.org/article/S2212-2672(14)01762-6/fulltext
17. Hao R, Qi X, Xia X, Wang L, Li X. Malnutrition on admission increases the in-hospital mortality and length of stay in elder adults with acute ischemic stroke. J Clin Lab Anal [Internet]. 2022 [cited 2024 Feb 15];36(1):e24132. Available from: https://pubmed.ncbi.nlm.nih.gov/34877710/. doi: 10.1002/jcla.24132
18. Codas M, Echague L, Ramírez L, Viveros C. Desnutrición en pacientes adultos internados del Hospital Regional de Encarnación, Paraguay. Rev virtual Soc Parag Med Int [Internet]. 2016 [citado 15 Feb 2024];3(1):11–21. Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S2312-38932016000100002. doi: https://doi.org/10.18004/rvspmi/2312-3893/2016.03(01)11-021
19. Liu W, Shi J, He S, Luo X, Zhong W, Yang F. Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model. PLoS One [Internet]. 2021 [cited 2024 Feb 15];16(3): e0248157. Available from: https://pubmed.ncbi.nlm.nih.gov/33711043/. doi: 10.1371/journal.pone.0248157
20. Regassa LD, Tola A. Magnitude and predictors of hospital admission, readmission, and length of stay among patients with type 2 diabetes at public hospitals of Eastern Ethiopia: a retrospective cohort study. BMC Endocr Disord [Internet]. 2021 [cited 2024 Mar 10];21(1):74. Available from: https://pubmed.ncbi.nlm.nih.gov/33866969/.doi: 10.1186/s12902-021-00744-3
21. Reyes Sanamé FA, Pérez Alvares ML, Medina Arce MM, Navarro Caboverde Y, Fernández Mendoza A. Aspectos clínicos y epidemiológicos de pacientes ingresados por diabetes mellitus de tipo 2 en el hospital de Moa. Medisan [Internet]. 2020 [citado 3 Abr 2024];24(6):1143–56. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192020000601143&lang=es
22. Seringa J, Marques AP, Moita B, Gaspar C, Raposo JF, Santana R. The impact of diabetes on multiple avoidable admissions: A cross-sectional study. BMC Health Serv Res [Internet]. 2019 [cited 2024 Feb 15];19(1):1002. Available from: https://pubmed.ncbi.nlm.nih.gov/31881962/. doi: 10.1186/s12913-019-4840-4
23. Skinner HG, Coffey R, Jones J, Heslin KC, Moy E. The effects of multiple chronic conditions on hospitalization costs and utilization for ambulatory care sensitive conditions in the United States: A nationally representative cross-sectional study. BMC Health Serv Res [Internet]. 2016 [cited 2024 Mar 10];16:77. Available from: https://pubmed.ncbi.nlm.nih.gov/26926525/. doi: 10.1186/s12913-016-1304-y
24. Mejia ChR, Paucar-Tito L, Morales-Concha L, Atamari-Anahui N, Rondón-Abuhadba EA, Ordoñez-Linares ME. Asociación entre tiempo de hospitalización y pie diabético: estudio transversal analítico en tres hospitales peruanos. Medwave [Internet]. 2018 [citado 15 Feb 2024];18(7):e7336. Disponible en: https://www.medwave.cl/investigacion/estudios/7336.html
25. Yang L, Li M, Shu J, Yang Y, Huang Q. A risk prediction model for prolonged length of stay in patients with acute exacerbations of chronic obstructive pulmonary disease: A retrospective study of 225 patients in a single center in Kunming China. Med Sci Monit [Internet]. 2022 [cited 2024 Feb 15];28:e934392. Available from: https://pubmed.ncbi.nlm.nih.gov/35136009/. doi: 10.12659/MSM.934392
Published
2025-01-08
Issue
Section
ARTICULOS ORIGINALES
