LOS Medicine per hospital admission: Difference between revisions

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{| class="wikitable" border=1 <hiddentext> set to 0 for no borders</hiddentext>
{{Reporting Indicators
|-   valign="top"
|description='''[[LOS | Length of stay]] in all medicine wards per [[Site and Location table | HOSPITAL]] ADMISSION'''
| width="139" height="27" | INDICATOR:
|indicator_start_date=2003-10-01
|style="font-size:11pt;font-weight:bold" width="585" | LENGTH OF STAY IN ALL  MEDICINE WARDS PER HOSPITAL  ADMISSION
|indicator_name={{PAGENAME}}
|program=Medicine
}}
Usually used in aggregate form as "per location" and/or "per reporting timeframe", e.g. month/quarter/year x Ward/Unit x Hospital.


|-  valign="top"
==Significance==
| height="35" | SIGNIFICANCE:
Length of stay (LOS) is influenced by many factors, but safe and effective care should result in shorter [[:Category: Length of stay | length of stay]].
| Length of stay (LOS) is influenced by many factors, but safe and effective care should result in shorter length of stay.


|-  valign="top"
==Start Dates==
| height="23" | DEFINITIONS:
*Oct 2003 to Sept 2020 - each record is per ward stay. A hospital stay may have one or more individual ward stay (or records).
| Average LOS reported for each ward in the region.
*Starting Oct 2020- each record is a continuous stay in any locations under Medicine service (or one Medicine episode) - see [[Definition of a Medicine Laptop Admission]]. If the patient is transferred to another service and comes back to Medicine service, this is a new record. A hospital stay may have one or more Medicine episodes.


|-   valign="top"
==Sampling Plan / Procedure==
| height="26" | SPECIFICATION:
===Inclusion Criteria===
| &nbsp;
All Medicine admissions - see [[Definition of a Medicine Laptop Admission]]
===Exclusion Criteria===
None
===Frequency===
* Reported the admission to the Medicine [[Service tmp entry|Service]] ends, ie when there is a [[Dispo DtTm]](Discharge Date)
* Monthly, quarterly, year based on discharged date of [[Dispo DtTm]]


|-  valign="top"
==Definition and Derivation==
| height="47" | Inclusion Criteria:
* Calculate the LOS for each record - refer to [[LOS Per Record]]
| All ward admissions in the Medicine Database [[MedTMS]].  If a patient is admitted to a Medicine service, stayed in one or more Medicine wards and then discharged from the hospital, the individual length of stays in each of the wards will be summed up. The LOS is accounted to the first ward the patient was admitted.
* Per patient, identify the records having the same [[Visit Admit DtTm]]. This implies same hospital stay or hospitalization.
 
* Per patient per hospitalization, sum up all the [[LOS Per Record]]
|-  valign="top"
** It is possible that the same patient may have one or more hospitalization within the same reporting time frame.
| height="25" | Exclusion Criteria:
| None
 
|-  valign="top"
| rowspan="2" height="28" | Required Variables  (Definition of Terms/) :
| '''Ward admit date/time''' – the date and time the patient is admitted to a ward.
 
|-  valign="top"
| '''Ward discharge date/time''' – the date and time the patient was discharge to a ward.
 
|-  valign="top"
| rowspan="3" height="25" | Calculation Procedure:
| '''Individual LOS per ward''' = Ward discharge date/time – Ward admit date/time (expressed in days).
 
|-  valign="top"
| '''LOS per patient''' = sum of individual LOS in all  the wards the patient stayed during a hospital stay.
 
|-  valign="top"
| '''Mean LOS Per Ward''' = average LOS from admissions to a ward  where discharge date of the last ward/service is between the beginning and the ending of the reporting time.
 
|- 
| height="23" | HOW REPORTED:
| Reported:  1)  by ward  of each  hospital.  2) by [[CTU]]s of each hospital in the region,
 
|-
| height="26" | WHERE & WHEN  REPORTED:
| [[Quarterly report | Quarterly]] and Fiscal Year Summary of Early Predictor of Adverse Outcome [[MOST]] Report.
=== Discussion ===
{{Discussion}}
*Hello Julie from Trish here in Wiki wonderland. Is the Fiscal year summary the same as Directors [[Annual report]]?  Trying to link to correct article or cateogry already planted on Wiki  so that you can quickly look up what is an annual or fiscal year summary or report. Sometime we use different names for the same thing.-- Let me know.--[[User:TOstryzniuk|TOstryzniuk]] 21:28, 2 February 2010 (CST)
 
|- 
| height="20" | PRESCRIBED BY:
| Dr Dan Roberts
 
|- 
| height="20" | TARGET:
| None yet.
 
|-  valign="top"
| rowspan="21" height="46" | COMMENT:
| The Medicine [[MedTMS]] and Critical [[TMSX]] Databases were combined to determine if a Medicine patient was admitted from ICU and/or have been transferred to ICU or another ward during a hospital stay.  Patient’s stay to different services within the hospital were linked and cumulative LOS only in the medicine wards was calculated.
 
|-  valign="top"
| Two ways to link the patients: '''1)''' Link the patient’s stay if  the patient is transferred to another ward, OR or an ICU within the hospital and the  second encounter  indicated  that it is so, t____?  '''2)''' Do not link the patient if the  next stay is a new admission.  
=== Discussion ===
{{Discussion}}
*Julie to check. Seem there may be a few word missing from original word doc.--[[User:TOstryzniuk|TOstryzniuk]] 20:55, 2 February 2010 (CST)
|-  valign="top"
|style="background-color:#C0C0C0;font-weight:bold" | Have used the second option – Criteria to determine a new admission: 
 
|-  valign="top"
| 1. Patient who have first and only admission
 
|-  valign="top"
| 2. Patient who left the hospital against medical advice (AMA) ([[Med Var 6 - AMA | Med Var 6]]), from previous admission
 
|-  valign="top"
| 3. When patient is transferred to a different hospital, the admission for that hospital ends and the patient becomes a new admission to the second hospital (except if reason is lab test and stay in the second hospital <1 day because bed is usually put on hold on the first hospital)
 
|-  valign="top"
| 4. Patient with previous encounter and now admitted from ER, home/long term care facility, outside city or province
 
|-  valign="top"
| 5. Patient with previous encounter that was discharged home/long term care facility, outside city or province and now admitted from unit within the hospital
 
|-  valign="top"
| 6. Patient who was previously discharged to OR/RR and now admitted from OR/RR for more than 7 days
 
|-  valign="top"
| 7. Patient who was previously discharged to a ward and now admitted from OR/RR (or vice versa) for more than 30 days
 
|-  valign="top"
| 8. Patient previously discharged to a ward and now admitted from a ward but the ward locations are now the same  
 
|-  valign="top"
| 9. None of the above but the gap in time between the two admissions is >90 days.
 
|-  valign="top"
|style="background-color:#C0C0C0;font-weight:bold" | Elements used in linking admissions:
 
|-
| valign="top" | 1.      PHIN, Last Name, First Name
 
|-
| valign="top" | 2.      Hospital
 
|-
| valign="top" | 3.      Ward/ICU
 
|-
| valign="top" | 4.      ‘Admit From’ location
 
|-
| valign="top" | 5.      ‘Discharge To’ location
 
|-
| valign="top" | 6.      Admit date/time
 
|-
| valign="top" | 7.      Discharge date/time
 
|-
| valign="top" | 8.      [[Med Var 1 - Admit-from Ward | Med Var 1]], [[Med Var 2 - Discharge-to Ward | Med Var 2]], [[Med Var 6 - AMA | Med Var 6]]]
 
|}


==Data Source==
* For dates refer to [[LOS Per Record]]
* For hospitalization date - use [[Visit Admit DtTm]]
* For patient identifier - use either [[Person ID]], [[Chart]], [[PHIN]]


== Reported as==
* Mean, median, sum, minimum, maximum (in days) per site and/or time frame
* N is the number of patient's hospitalizations
* Counts and % of N based on LOS groups (<1,1-5,6-10,11-15-16-20,>20) for a given reporting time frame and/or site


==SAS Program==
S:\MED\MED_CCMED\Julie\SAS_CFE\Med_reports\1_prepMed_startingJan2021_26Aug2021.sas S:\MED\MED_CCMED\Julie\SAS_CFE\Med_reports\3_CFE_MedReportPart1_startingJan2021_16aug2021.sas


== Related Articles ==
{{Related Articles}}


[[Category: Length of stay]]
[[Category: Length of stay]]
[[Category: Reporting]]
[[Category: Multiple Encounter]]

Latest revision as of 11:28, 2021 December 22

Length of stay in all medicine wards per HOSPITAL ADMISSION

Indicators
Indicator: LOS Medicine per hospital admission
Created/Raw: not stated
Program: Medicine
Start Date: 2003-10-01
End Date:
Reports: Directors Quarterly and Annual Report (Medicine)


  • Cargo


  • SMW:
    • "not stated" is not in the list (Created, Raw) of allowed values for the "IndicatorCreatedRaw" property.
  • Categories
  • Default form:

Usually used in aggregate form as "per location" and/or "per reporting timeframe", e.g. month/quarter/year x Ward/Unit x Hospital.

Significance

Length of stay (LOS) is influenced by many factors, but safe and effective care should result in shorter length of stay.

Start Dates

  • Oct 2003 to Sept 2020 - each record is per ward stay. A hospital stay may have one or more individual ward stay (or records).
  • Starting Oct 2020- each record is a continuous stay in any locations under Medicine service (or one Medicine episode) - see Definition of a Medicine Laptop Admission. If the patient is transferred to another service and comes back to Medicine service, this is a new record. A hospital stay may have one or more Medicine episodes.

Sampling Plan / Procedure

Inclusion Criteria

All Medicine admissions - see Definition of a Medicine Laptop Admission

Exclusion Criteria

None

Frequency

  • Reported the admission to the Medicine Service ends, ie when there is a Dispo DtTm(Discharge Date)
  • Monthly, quarterly, year based on discharged date of Dispo DtTm

Definition and Derivation

  • Calculate the LOS for each record - refer to LOS Per Record
  • Per patient, identify the records having the same Visit Admit DtTm. This implies same hospital stay or hospitalization.
  • Per patient per hospitalization, sum up all the LOS Per Record
    • It is possible that the same patient may have one or more hospitalization within the same reporting time frame.

Data Source

Reported as

  • Mean, median, sum, minimum, maximum (in days) per site and/or time frame
  • N is the number of patient's hospitalizations
  • Counts and % of N based on LOS groups (<1,1-5,6-10,11-15-16-20,>20) for a given reporting time frame and/or site

SAS Program

S:\MED\MED_CCMED\Julie\SAS_CFE\Med_reports\1_prepMed_startingJan2021_26Aug2021.sas S:\MED\MED_CCMED\Julie\SAS_CFE\Med_reports\3_CFE_MedReportPart1_startingJan2021_16aug2021.sas

Related Articles

Related articles:
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