Predictors of Hospital Length of Stay and Readmissions in Ischemic Stroke Patients and the Impact of Inpatient Medication Management

Arinze Nkemdirim Okere; Colleen M Renier; Angela Frye

doi:10.1016/j.jstrokecerebrovasdis.2016.04.011

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Predictors of Hospital Length of Stay and Readmissions in Ischemic Stroke Patients and the Impact of Inpatient Medication Management

Journal article

Peer reviewed

Predictors of Hospital Length of Stay and Readmissions in Ischemic Stroke Patients and the Impact of Inpatient Medication Management

Arinze Nkemdirim Okere, Colleen M Renier and Angela Frye

Journal of stroke and cerebrovascular diseases, Vol.25(8), pp.1939-1951

08/01/2016

DOI: 10.1016/j.jstrokecerebrovasdis.2016.04.011

PMID: 27199200

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Abstract

This study was designed to evaluate predictors of hospital length of stay (LOS) and readmissions among nonsurgical ischemic stroke patient, and the impact of inpatient medication management. This retrospective cohort study includes adult patients (≥18 years) hospitalized with a diagnosis of nonsurgical ischemic stroke from November 2007 to March 2013. In November 2011, an inpatient medication management model was implemented in the stroke unit. At the end of the study period, patients were matched before and after implementation of the inpatient medication management model (non-PHC [pharmacist-hospitalist collaborative] and PHC, respectively) to evaluate change in outcomes. The primary outcome of the study is an evaluation of predictive factors affecting LOS and readmissions. Additionally, changes in LOS and all-cause readmission at 30, 60, and 90 days when compared between PHC and non-PHC were evaluated. A total of 151 PHC patients were matched to 248 non-PHC patients. There was no difference in LOS between the PHC and non-PHC patients (mean adjusted difference -.14; P = .66). Similar finding was observed for readmissions (P > .05). Insurance type was a significant predictor of LOS, with Medicare patients having an extended LOS compared to patients with private insurance (mean difference -1.00; P = .005). Patients taking statins and patients aged less than 80 years had a lower 30-day readmission rate compared to nonstatin users and patients aged 80 years or older, respectively (P < .05). Insurance type and severity of illness are important predictors of LOS, whereas readmissions are mostly influenced by age and statin use.

Brain Ischemia - complications

Cohort Studies

Disease Management

Female

Humans

Inpatients

Length of Stay - statistics & numerical data

Male

Patient Readmission - statistics & numerical data

Predictive Value of Tests

Stroke - etiology

Stroke - therapy

Treatment Outcome

Details

Title: Subtitle: Predictors of Hospital Length of Stay and Readmissions in Ischemic Stroke Patients and the Impact of Inpatient Medication Management
Creators: Arinze Nkemdirim Okere - Florida Agricultural and Mechanical University
Colleen M Renier - Essentia Health
Angela Frye - Corewell Health Butterworth Hospital
Resource Type: Journal article
Publication Details: Journal of stroke and cerebrovascular diseases, Vol.25(8), pp.1939-1951
DOI: 10.1016/j.jstrokecerebrovasdis.2016.04.011
PMID: 27199200
ISSN: 1052-3057
eISSN: 1532-8511
Language: English
Date published: 08/01/2016
Academic Unit: Pharmacy Practice and Science; Internal Medicine
Record Identifier: 9984845053502771

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