Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Previous studies in adults admitted to pediatric hospitals primarily investigated associations between complex chronic condition characteristics and patient outcomes. Our study explored the association of age with length of stay (LOS) and total cost in these adults, accounting for other patient factors. ⋯ There was a significant positive association between age and total cost, with adults 18-20 years having 13% higher total cost (95% confidence interval [CI]: 12%-15%), 21-25 years with 25% higher total cost (95% CI: 22%-29%), and 25-99 years having 72% higher total cost (95% CI: 66%-79%) than 1-17 years. Our findings suggest expanding upon the existing status quo to identify the most appropriate environment to care for this unique and growing population, especially given the anticipated reduction in pediatric beds and subspecialty expertise.
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Elevated care at home (ECH) is a novel in-home care model supporting early hospital discharge and providing an alternative to institutional postacute care. ⋯ ECH had similar or improved outcomes relative to SNF and SHH. COVID-19-negative ECH patients experienced higher readmissions relative to SNF. ECH supported patients to return home from the hospital and provided an alternative to an institutional postacute setting.
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Veterans Health Administration (VHA) enrollees may use community hospitals for inpatient care and sometimes require transfer to larger community or VHA hospitals. Little is known about interhospital transfer patterns among veterans using community and VHA hospitals or how coronavirus disease 2019 (COVID-19) case surges affected transfer. ⋯ Interhospital transfer was common for veterans with AMI and AIS, especially among rural veterans. Few transfers were to VHA hospitals. COVID-19 case surges were associated with decreased transfer for veterans with AMI, potentially limiting access to needed care.