Dataset Information

Outcomes of a Neurohospitalist Program at an Academic Medical Center.

ABSTRACT:

Background and purpose

The purpose is to determine the impact of an academic neurohospitalist service on clinical outcomes.

Methods

We performed a retrospective, quasi-experimental study of patients discharged from the general neurology service before (August 2010-July 2014) and after implementation of a full-time neurohospitalist service (August 2016-July 2018) compared to a control group of stroke patients. Primary outcomes were length of stay and 30-day readmission. Using the difference-in-difference approach, the impact of introducing a neurohospitalist service compared to controls was assessed with adjustment of patients' characteristics. Secondary outcomes included mortality, in-hospital complications, and cost.

Results

There were 2706 neurology admissions (1648 general; 1058 stroke) over the study period. The neurohospitalist service was associated with a trend in reduced 30-day readmissions (ratio of ORs: .52 [.27, .98], P = .088), while length of stay was not incrementally changed in the difference-in-difference model (-.3 [-.7, .1], P = .18). However, descriptive results demonstrated a significant reduction in mean adjusted LOS of .7 days (4.5 to 3.8 days, P < .001) and a trend toward reduced readmissions (8.9% to 7.6%, P = .42) in the post-neurohospitalist cohort despite a significant increase in patient complexity, shift to higher acuity diagnoses, more emergent admissions, and near quadrupling of observation status patients. Mortality and in-hospital complications remained low, patient satisfaction was stable, and cost was not incrementally changed in the post-neurohospitalist cohort.

Conclusions

Implementation of a neurohospitalist service at an academic medical center is feasible and associated with a significant increase in patient complexity and acuity and a trend toward reduced readmissions.

SUBMITTER: Gold CA

PROVIDER: S-EPMC9214938 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Outcomes of a Neurohospitalist Program at an Academic Medical Center.

Gold Carl A CA Scott Brian J BJ Weng Yingjie Y Bernier Eric E Kvam Kathryn A KA

The Neurohospitalist 20220422 3

<h4>Background and purpose</h4>The purpose is to determine the impact of an academic neurohospitalist service on clinical outcomes.<h4>Methods</h4>We performed a retrospective, quasi-experimental study of patients discharged from the general neurology service before (August 2010-July 2014) and after implementation of a full-time neurohospitalist service (August 2016-July 2018) compared to a control group of stroke patients. Primary outcomes were length of stay and 30-day readmission. Using the d ...[more]

PMID: 35755235

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Dataset Information

Outcomes of a Neurohospitalist Program at an Academic Medical Center.

Background and purpose

Methods

Results

Conclusions

Publications

Outcomes of a Neurohospitalist Program at an Academic Medical Center.

Similar Datasets

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