Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012

Brad Wright; Amy M.J O'Shea; Justin M Glasgow; Padmaja Ayyagari; Mary Vaughan-Sarrazin

doi:10.1097/MD.0000000000004802

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Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012

Journal article

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Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012

Brad Wright, Amy M.J O'Shea, Justin M Glasgow, Padmaja Ayyagari and Mary Vaughan-Sarrazin

Medicine (Baltimore), Vol.95(36), pp.e4802-e4802

2016

DOI: 10.1097/MD.0000000000004802

PMCID: PMC5023914

PMID: 27603391

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Abstract

Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals. The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals. Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient and enrollment files, American Hospital Association Survey, and Area Health Resource File. We used these data to estimate linear regression models of hospitals’ observation stay rates as a function of hospital, patient, and local health system characteristics, while controlling for time trends and Veterans Integrated Service Network level fixed effects. We found that observation stay rates are inversely related to hospital bed size and that hospitals with a greater proportion of younger or rural patients have higher observation stay rates. Observation stay rates were nearly 15 percentage points higher in 2012 than 2005. Although we identify several characteristics associated with variation in VHA hospital observation stay rates, many factors remain unmeasured.

veterans health administration

hospitals

practice variation

observation stays

5400

longitudinal analysis

Observational Study

Details

Title: Subtitle: Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012
Creators: Brad Wright - Department of Health Management and Policy
Amy M.J O'Shea - Iowa City Veterans Affairs Healthcare System, The Comprehensive Access and Delivery Research and Evaluation Center (CADRE)
Justin M Glasgow - Christiana Care Health System Department of Internal Medicine and Christiana Care Health System Value Institute, Wilmington, DE
Padmaja Ayyagari - Department of Health Management and Policy
Mary Vaughan-Sarrazin - Iowa City Veterans Affairs Healthcare System, The Comprehensive Access and Delivery Research and Evaluation Center (CADRE)
Resource Type: Journal article
Publication Details: Medicine (Baltimore), Vol.95(36), pp.e4802-e4802
DOI: 10.1097/MD.0000000000004802
PMID: 27603391
PMCID: PMC5023914
NLM abbreviation: Medicine (Baltimore)
ISSN: 0025-7974
eISSN: 1536-5964
Publisher: Wolters Kluwer Health
Language: English
Date published: 2016
Academic Unit: Health Management and Policy; Public Policy Center (Archive); General Internal Medicine; Internal Medicine
Record Identifier: 9984064194102771

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