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- W2912038093 abstract "Neurohospitalist programs have been hypothesized to improve the cost and quality of care. Since data supporting the cost-effectiveness of neurohospitalist programs is lacking, this study aims to compare the LOS of patients discharged with a diagnosis of ischemic stroke after implementation of a neurohospitalist program in a tertiary care center. A retrospective review was performed utilizing data obtained through Premier Quality Advisor to evaluate LOS for all patients discharged from Geisinger Medical Center in Danville, Pennsylvania diagnosed with ischemic stroke between July 2014 and July 2018. A neurohospitalist service was introduced in July 2016 and observed LOS was compared to expected LOS pre- and post-implementation. Data for expected LOS was obtained through CareScience Analytics Risk-adjusted regression analysis of hundreds of hospital systems utilizing Premier Quality Advisor. To further control for case complexity as a confounding variable of LOS, we excluded patients discharged by critical care and surgical services. A total of 1,856 patients were discharged with the principal diagnosis of ischemic stroke over the four-year study period. Pre-implementation 890 patients were discharged with an observed geometric mean LOS (GMLOS) of 3.47 days compared to an expected GMLOS of 3.66 days (variation -0.19, p<0.01). Post-implementation 322 patients were attended by hospital medicine with an observed GMLOS of 4.43 days, expected GMLOS of 3.93 days (variation 0.51, P<0.01). Over the same period the neurohospitalist service discharged 643 patients with an observed GMLOS of 2.97 days, expected GMLOS of 3.27 days (variation -0.3, P<0.01). In conclusion, the neurohospitalist service significantly reduced the length of stay of ischemic stroke patients compared to expected values. Absolute length of stay was also reduced compared to care pre-implementation and care provided by the medicine hospitalists. This data supports the hypothesis that neurohospitalists improve the quality and cost-effectiveness of stroke care." @default.
- W2912038093 created "2019-02-21" @default.
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- W2912038093 date "2019-02-01" @default.
- W2912038093 modified "2023-09-26" @default.
- W2912038093 title "Abstract WP410: Effect of a Neurohospitalist Service on Length of Stay of Ischemic Stroke Patients" @default.
- W2912038093 doi "https://doi.org/10.1161/str.50.suppl_1.wp410" @default.
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