Abstract:
BACKGROUND:The economic burden of acute kidney injury (AKI) is not well understood. OBJECTIVE:To estimate the effects of AKI on hospitalization costs and length of stay (LOS). DESIGN:Using data from the 2012 National Inpatient Sample, we compared hospitalization costs and LOS with and without AKI. We used a generalized linear model with a gamma distribution and a log link fitted to AKI to adjust for demographics, hospital differences, and comorbidities. SETTING:United States. PATIENTS:29,763,649 adult hospitalizations without endstage renal disease. EXPOSURE:AKI determined using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes.. MEASUREMENTS:Hospitalization costs and LOS. RESULTS:AKI was associated with an increase in hospitalization costs of $7933 (95% confidence interval [CI], $7608-$8258) and an increase in LOS of 3.2 (95% CI, 3.2-3.3) days compared to patients without AKI. When adjusted for patient and hospital characteristics, the associated increase in costs was $1795 (95% CI, $1692-$1899) and in LOS, it was 1.1 (95% CI, 1.1-1.1) days. Corresponding results among patients hospitalized with AKI requiring dialysis were $42,077 (95% CI, $39,820-$44,335) and 11.5 (95% CI, 11.2-11.8) days and $11,016 (95% CI, $10,468-$11,564) and 3.9 (95% CI, 3.8-4.1) days. AKI was associated with higher hospitalization costs than myocardial infarction and gastrointestinal bleeding, and costs were comparable to those for stroke, pancreatitis, and pneumonia.. CONCLUSIONS:In the United States, AKI is associated with excess hospitalization costs and prolonged LOS. The economic burden of AKI warrants further attention from hospitals and policymakers to enhance processes of care and develop novel treatment strategies. Journal of Hospital Medicine 2017;12:70-76.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Silver SA,Long J,Zheng Y,Chertow GMdoi
10.12788/jhm.2683subject
Has Abstractpub_date
2017-02-01 00:00:00pages
70-76issue
2eissn
1553-5592issn
1553-5606journal_volume
12pub_type
杂志文章abstract:OBJECTIVE:There have been no recent studies describing the management and outcomes of patients with infective endocarditis (IE). PATIENTS AND METHODS:We conducted a retrospective cohort study of adult patients admitted to a tertiary medical center from 2007 to 2011 with a Duke criteria consistent discharge diagnosis o...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2746
更新日期:2017-06-01 00:00:00
abstract::Venous access is the foundation for safe and effective hospital-based care. Inpatient providers must have a deep knowledge of the different types of venous access devices (VADs), their relative indications, contraindications, and appropriateness. However, such knowledge is difficult to come by and usually only gleaned...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Best practice alerts (BPAs) provide clinical decision support (CDS) at the point of care to reduce unnecessary blood product transfusions, yet substantial transfusions continue outside of recommended guidelines. OBJECTIVE:To understand why providers order blood transfusions outside of recommended guidelines...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2015-01-01 00:00:00
abstract::Current hospital readmission measures are part of the Centers for Medicare & Medicaid Services Five-Star Quality Rating System but are inadequate for reporting hospital quality. We review potential biases in the readmission measures and offer policy recommendations to address these biases. Hospital readmission rates a...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2799
更新日期:2017-12-01 00:00:00
abstract::We examined whether placing a painting in the line of vision of a hospitalized patient improves patient outcomes and satisfaction and whether having patients choose their paintings offers greater benefit. From 2014 to 2016, we enrolled 186 inpatients with cancer diagnoses from Pennsylvania State University Cancer Inst...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2018-08-01 00:00:00
abstract::The accountable care organization (ACO) concept is advocated as a promising value-based payment model that could successfully realign the current payment system to financially reward improvements in quality and efficiency. Focusing on the care of hospitalized patients and controlling a substantive portion of variable ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2965
更新日期:2018-04-01 00:00:00
abstract:WHAT'S NEW:This is the first study of a pediatric hospitalist preoperative clinic. Pediatric hospitalists frequently make significant recommendations for patients with neuromuscular scoliosis prior to spinal surgery, especially those with medical complexity. Certain clinical criteria are statistically significantly ass...
journal_title:Journal of hospital medicine
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更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Patients with suspected thiamine deficiency should receive treatment with parenteral thiamine to achieve the high serum thiamine levels necessary to reverse the effects of deficiency and to circumvent problems with absorption common in the medically ill. OBJECTIVE:To quantify rates of parenteral administrat...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
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更新日期:2015-04-01 00:00:00
abstract::Physicians are notorious for poor hand hygiene (HH) compliance. We wondered if lower performance by physicians compared with other health professionals might reflect differences in the Hawthorne effect. We introduced covert HH observers to see if performance differences between physicians and nurses decreased and to g...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2632
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Previous local quality improvement focused on discharging patients with inhaled corticosteroids (ICS) "in-hand" decreased healthcare reutilization after hospitalization for an asthma exacerbation. However, as a result of these new processes, some patients admitted for an asthma exacerbation rec...
journal_title:Journal of hospital medicine
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abstract:BACKGROUND:Care coordination is critical in settings characterized by high levels of uncertainty, time constraints, and interdependent work processes. The effects of provider characteristics on coordination in comanaged teams has never been examined. OBJECTIVE:To characterize individual providers based on their contri...
journal_title:Journal of hospital medicine
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更新日期:2010-11-01 00:00:00
abstract::Women continue to be underrepresented as speakers at national conferences, and research has shown similar trends in hospital medicine. The Society of Hospital Medicine (SHM) Annual Meeting has historically had an open call peer review process for workshop speakers and, in 2019, expanded the process for didactic speake...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Outpatient parenteral antimicrobial therapy (OPAT) is a safe way to administer intravenous (IV) antimicrobial therapy to patients with the potential to decrease hospital length of stay (LOS). Often, homeless patients with complex infections, who could otherwise be treated as an outpatient, remain in the hosp...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2016-08-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2260
更新日期:2015-01-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2021-01-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2017-08-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2019-04-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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journal_title:Journal of hospital medicine
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journal_title:Journal of hospital medicine
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更新日期:2016-06-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2009-02-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:Journal of hospital medicine
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更新日期:2019-01-02 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2012-05-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2015-08-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2010-02-01 00:00:00
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更新日期:2019-03-01 00:00:00
abstract:BACKGROUND: OBJECTIVE: DESIGN, SETTING, PATIENTS: INTERVENTION: MEASUREMENTS: CONCLUSIONS: ...
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更新日期:2019-02-01 00:00:00
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更新日期:2013-12-01 00:00:00