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Developing a.ditiona. Hospita. Ca.a.ity a. the Community Level

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Ca.e Reports in Clinica. Medicine 2022年第1期11卷 1-7页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse USA

Hospita.s in the United Sta.es a.e being cha.lenged to provide the ca.a.ity for a.ult medicine a.d surgery ca.e. The study suggested tha. the hospita.s of Syra.use, New York ha.e genera.ed a.ditiona. inpa.ient ca.a.ity through a.number of efforts. One progra. involved moving some low severity of illness inpa.ient procedures to a.bula.ory ca.e. a.different a.proa.h ha. a.so a.oided inpa.ient utiliza.ion by diverting incoming a.bula.ces to different providers. The third progra. eva.ua.ed in the study, length of sta. reduction, wa. a.different type of initia.ive. It ha. genera.ed a.ditiona. inpa.ient ca.a.ity by reducing the a.ount of inpa.ient ca.e provided. In effect, it ha. increa.ed inpa.ient ca.a.ity by a.dressing the efficiency of ca.e. These progra.s illustra.e the potentia. for improving hospita. ca.a.ity a. the community level. Ea.h of them wa. developed by a.ute ca.e providers using loca. services.

关键词： Hospita.s Hospita. Emergency Depa.tments Hospita. Lengths of Sta.

Eva.ua.ing Hospita. Utiliza.ion La.e in the Epidemic

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Ca.e Reports in Clinica. Medicine 2022年第7期11卷 261-267页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse NY USA

This study eva.ua.ed present a.d future impa.t of the corona.irus on hospita.iza.ion a. the virus winds down in the metropolita. a.ea.of Syra.use, New York. The study compa.ed a.ult medicine a.d a.ult surgery discha.ges between Ja.ua.y-Ma. 2019 a.d 2022. The da.a.indica.ed tha. 69 percent of the reduction in medica.-surgica. discha.ges tha. occurred since 2019 wa. offset during 2022. The rema.ning 31 percent rema.ned a. levels experienced in 2020 a.d 2021. The study clea.ly demonstra.ed tha. medica. a.d surgica. discha.ges increa.ed significa.tly since 2019. a. importa.t question is whether these will continue or if they will level off.

关键词： Hospita.s Infectious Disea.es Hospita.iza.ion

Estima.ing the Potentia. for Reduction of Hospita. Ca.a.ity a. the Community Level

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a.va.ces in Bioscience a.d Biotechnology 2016年第4期7卷 225-231页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse NY USA

This study estima.ed the potentia. impa.t of the na.ionwide shift from inpa.ient to outpa.ient ca.e in the hospita.s of Syra.use, New York, a.sma.l metropolita. a.ea.with a.rela.ively sta.le popula.ion. The study employed the 3MTM a.l Pa.ients Refined Dia.nosis Group Severity of Illness system to identify inpa.ients a.d rela.ed utiliza.ion with the grea.est potentia. for movement from inpa.ient to outpa.ient settings. The study da.a.suggested tha. the development of a.ditiona. a.bula.ory ca.e ca.a.ity in Syra.use could support the reduction of a. a.era.e da.ly census of a.proxima.ely 60 - 125 pa.ients with low severity of illness, excluding rea.missions. The study da.a.a.so identified the potentia. for shifting a. a.era.e da.ly census of a.proxima.ely 9 - 19 pa.ients who were rea.mitted to hospita.s within 30 da.s of their initia. a.missions from inpa.ient to outpa.ient ca.e. The study da.a.a.so identified the potentia. for reduction of a. a.era.e da.ly census of a.proxima.ely 20 - 70 a.ult medicine a.d a.ult surgery pa.ients through continued initia.ives for inpa.ient length of sta. reduction. The impa.t of initia.ives in ea.h of these a.ea. could result in a.reduction of the combined a.era.e da.ly a.ult medicine a.d a.ult surgery census of the Syra.use hospita.s from a.proxima.ely 90 to 215 pa.ients. This would a.ount to between 8 a.d 20 percent of the current inpa.ient census for a.ult medicine a.d a.ult surgery. These da.a.suggest tha. pla.ning for initia.ives such a. a.bula.ory ca.e development a.d reduction of rea.missions should a.so include eva.ua.ion of their impa.t on inpa.ient a.ute ca.e a.d rela.ed services.

关键词： Hospita. Utiliza.ion Hospita. a.missions Hospita. Rea.missions Hospita. Lengths of Sta.

Reducing Extended Hospita. Lengths of Sta.

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Ca.e Reports in Clinica. Medicine 2024年第5期13卷 171-177页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse NY USA

In the United Sta.es, the costs of hea.th ca.e ha.e become a.ma.or burden for the hea.th ca.e system. In order to a.dress this problem, the hospita.s of Syra.use, New York, developed progra.s to provide suba.ute a.d complex ca.e. The Suba.ute progra.s provided pa.ient tra.sporta.ion services for dia.ysis a.d other types of ca.e outside hospita.s. They a.so developed progra.s for services such a. intra.enous thera.y in nursing homes. The Complex Ca.e Progra.s, such a. intra.enous thera.y a.d menta. hea.th services, ha.e provided a.terna.ives to extended ca.e in hospita.s. During the pa.t five yea.s, utiliza.ion of these progra.s ha. va.ied, declining between 2019 a.d 2022, a.d then increa.ing between 2022 a.d 2024. The progra.s ha.e a.oided the need for 1530 - 2974 pa.ient da.s in hospita.s. The progra.s sa.ed the Syra.use hospita.s a.proxima.ely $600 per inpa.ient da.. This a.ounted to sa.ings of $918,000 - $1,784,400 per yea.. These progra.s demonstra.ed how rela.ively sma.l mecha.isms ca. sa.e la.ge a.ounts of hea.th ca.e resources.

关键词： Hospita.s Hospita. Efficiency Hospita. Lengths of Sta.

Supporting Efficiency in Hea.th Ca.e a. the Community Level

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Ca.e Reports in Clinica. Medicine 2021年第8期10卷 213-219页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse NY USA

Hea.th ca.e providers a.d pa.ers in the United Sta.es ha.e worked to provide ca.e a. rea.ona.le costs. This ha. frequently been a.cha.lenge. For exa.ple, the COVID epidemic ha. genera.ed la.ge expenditures with limited efforts to conta.n costs. Ba.ed on the experiences of providers in Syra.use, New York, this study suggested tha. rea.istic a.proa.hes a.e necessa.y to improve hea.th ca.e efficiency. It described three progra.s tha. ha.e improved utiliza.ion a. the community level. They ha.e included the diversion of la.ge numbers of a.bula.ces tha. directed pa.ients to emergency depa.tments where ca.e wa. most a.a.la.le. They ha.e a.so involved length of sta. reduction tha. sa.ed thousa.ds of pa.ient da.s a.d ma.e a.ditiona. inpa.ient ca.e a.a.la.le in hospita.s. They ha.e a.so included the use of a.bula.ory surgery to reduce the need for inpa.ient ca.e. The da.a.from these progra.s demonstra.ed tha. efforts to improve the efficiency of ca.e ca. reduce inpa.ient utiliza.ion a.d improve outcomes. The Syra.use hospita.s ha.e used them to ma.e a.ditiona. ca.a.ity a.a.la.le for COVID pa.ients a.d other popula.ions.

关键词： Hospita.s a.bula.ce Diversion Hospita. Lengths of Sta. a.bula.ory Surgery

Cha.ges in Hospita. Utiliza.ion a. the Community Level

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Ca.e Reports in Clinica. Medicine 2023年第8期12卷 285-291页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse USA

This study eva.ua.ed developments in a.ult medicine a.d a.ult surgery inpa.ient discha.ges of the Syra.use, New York metropolita. a.ea.during a.five-yea. period. The study demonstra.ed tha. a.ult medicine discha.ges declined by 19.1 percent a.d a.ult surgery discha.ges declined by 25.1 percent between Ja.ua.y-a.ril 2019 a.d 2023. The study a.so indica.ed tha. discha.ges for both services increa.ed slightly, 2.8 - 6.2 percent, between Ja.ua.y-a.ril 2022 a.d 2023. The study da.a.suggested tha. some of the reduction in a.ult medicine discha.ges resulted from less use of hea.th ca.e services rela.ed to the corona.irus epidemic. It a.so demonstra.ed tha. reduced use of a.ult surgery services wa. a.socia.ed with grea.er utiliza.ion of a.bula.ory surgery a.d other outpa.ient services in the community. The results of the study suggested tha. hospita.s in the United Sta.es ma. experience less utiliza.ion of inpa.ient services in the future.

关键词： Hospita.s Hospita. Discha.ges Hospita. Utiliza.ion

Estima.ing the Future of Hea.th Ca.e a. the Community Level

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Ca.e Reports in Clinica. Medicine 2024年第7期13卷 241-248页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse NY USA

Developments in hea.th ca.e in the United Sta.es a.e cha.ging the delivery of services for providers a.d pa.ors. This study focused on inpa.ient hospita. discha.ges in the Syra.use hospita.s a.d other services. It demonstra.ed tha., during the pa.t five yea.s, numbers of inpa.ient a.ult medicine discha.ges ha. increa.ed while a.ult surgery discha.ges ha. declined. This informa.ion suggested tha. a.ult medicine discha.ges could be expected to increa.e a.d a.proa.h levels of five yea.s a.o. It a.so suggested a.ult surgery discha.ges could be expected to rema.n a. previous levels or decline. This informa.ion indica.ed tha. the combined emergency depa.tment visits declined from 238,000 to 202,000 between 2019 a.d 2020, then increa.ed from 218,000 to 228,000 visits between 2021 a.d 2023. These developments will proba.ly result in grea.er efficiency a. the community level. With a.decline in numbers of inpa.ient beds, providers will be a.le to focus on the more efficient ma.a.ement by reducing numbers of sta.f a. well a. fewer pha.ma.eutica.s a.d testing.

关键词： Hospita.s Long Term Ca.e Hea.th Ca.e Costs

Hospita. Utiliza.ion a.d Hea.th Ca.e Pla.ning

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Ca.e Reports in Clinica. Medicine 2022年第12期11卷 520-526页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse NY USA

This study eva.ua.ed cha.ges in inpa.ient a.ult medicine a.d a.ult surgery services in the metropolita. a.ea.of Syra.use New York. These a.e the two la.gest inpa.ient hospita. services. The study involved the use of these services a. a.ba.is for hea.th ca.e pla.ning over time. The first component of the study focused on cha.ges in hospita. discha.ges for a.ult medicine a.d a.ult surgery. It demonstra.ed tha., between the first three qua.ters of 2019 a.d 2022, before a.d a.ter the corona.irus epidemic, numbers of a.ult medicine a.d a.ult surgery discha.ges declined by 16 - 21 percent. The second component of the study focused on cha.ges in hospita. lengths of sta. for a.ult medicine a.d a.ult surgery. It demonstra.ed tha., between the first three qua.ters of 2019 a.d 2022, hospita. inpa.ient lengths of sta. increa.ed by a.proxima.ely 19 - 21 percent a. the a.grega.e a.d hospita. specific levels. Effective pla.ning involving utiliza.ion indica.ors such a. hospita. discha.ges a.d efficiency will be necessa.y if the potentia. for effective ma.a.ement of this sector is to be preserved. This pla.ning should involve compa.isons of da.a.such a. hospita. discha.ges a.d sta.s, a.d identifica.ion of the sources of these developments a. the community level.

关键词： Hospita.s Hospita. Discha.ges Hea.th Pla.ning

Cha.ges in Inpa.ient Hospita. Utiliza.ion a. the Community Level

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Ca.e Reports in Clinica. Medicine 2024年第9期13卷 358-365页

作者： Rona.d La.oe shelly littau Hospita. Executive Council Syracuse NY USA

This study demonstra.ed tha. numbers of hospita. inpa.ient discha.ges ha.e declined in the metropolita. a.ea.of Syra.use, New York. The la.gest impa.t ha. been in a.ult medicine a.d a.ult surgery, the hospita. services with the highest utiliza.ion ra.es. Reductions in inpa.ient ca.e ha.e a.so a.fected services with lower utiliza.ion, such a. pedia.rics, obstetrics, a.d menta. hea.th. The study indica.ed tha., between Ja.ua.y - June 2019 a.d 2024, a.ult medicine discha.ges declined by 11.9 percent a.d a.ult surgery discha.ges declined by 24.6 percent. a.la.ge proportion of the reductions involved orthopedic surgery. They indica.ed tha. more tha. 50 percent of the joint repla.ements in the Syra.use hospita.s ha.e been moved to outpa.ient services. These pa.ients included those with low severity of illness. The study suggested tha. reductions in hospita. discha.ges could contribute to the efficiency of ca.e. Fewer inpa.ient a.missions could reduce the need for sta.fing a.d other resources. Informa.ion from the Syra.use hospita.s ha. suggested tha. these reductions ma. continue.

关键词： Hospita.s Hospita. Inpa.ients a.ult Medicine a.ult Surgery