Maniaci Michael J, Chadha Ryan M, Fazio Jacey R, Maita Karla C, Love Ellen A, Boyle Venessa L, Heckman Michael G, Johnson Patrick W, Paulson Margaret R, Forte Antonio J
Division of Hospital Internal Medicine.
Department of Anesthesiology.
Ann Med Surg (Lond). 2023 Apr 19;85(5):1578-1583. doi: 10.1097/MS9.0000000000000704. eCollection 2023 May.
Mayo Clinic's Care Hotel is a virtual hybrid care model which allows postoperative patients to recover in a comfortable environment after a low-risk procedure. Hospitals need to understand the key patient factors that promote acceptance of the Care Hotel if they are to benefit from this innovative care model. This study aims to identify factors that can predict whether a patient will stay at Care Hotel.
This retrospective chart review of 1065 patients was conducted between 23 July 2020, and 31 December 2021. Variables examined included patient age, sex, race, ethnicity, Charlson comorbidity index, distance patient travelled to hospital, length of surgery, day of the week of surgery, and surgical service. Associations of patient and surgery characteristics with the primary outcome of staying at the Care Hotel were assessed using unadjusted and multivariable logistic regression models.
Of the 1065 patients who met criteria for admission to the Care Hotel during the study period, 717 (67.3%) chose to stay at the Care Hotel while 328 (32.7%) choose to be admitted to the hospital. In multivariable analysis, there was a significant association between surgical service and staying at the Care Hotel (<0.001). Specifically, there was a higher likelihood of staying at the Care Hotel for patients from Neurosurgery [odds rato (OR)=1.86, =0.004], Otorhinolaryngology (OR=2.70, <0.001), and General Surgery (OR=2.75, =0.002). Additionally, there was a higher likelihood of staying at the Care Hotel with distance travelled over 110 miles [OR (per each doubling)=1.10, =0.007].
When developing a post-surgical care model for patients following outpatient procedures, the referring surgical service is a primary factor to consider in order to ensure patient acceptance, along with patient distance. This study can assist other healthcare organizations considering this model, as it provides guidance on which factors are most indicative of acceptance.
梅奥诊所的护理酒店是一种虚拟混合护理模式，允许低风险手术后的患者在舒适的环境中康复。如果医院想要从这种创新护理模式中获益，就需要了解促进患者接受护理酒店的关键因素。本研究旨在确定能够预测患者是否会入住护理酒店的因素。
对2020年7月23日至2021年12月31日期间的1065例患者进行了回顾性病历审查。检查的变量包括患者年龄、性别、种族、民族、查尔森合并症指数、患者到医院的距离、手术时长、手术的星期几以及手术科室。使用未调整和多变量逻辑回归模型评估患者和手术特征与入住护理酒店这一主要结局之间的关联。
在研究期间符合入住护理酒店标准的1065例患者中，717例（67.3%）选择入住护理酒店，而328例（32.7%）选择入住医院。在多变量分析中，手术科室与入住护理酒店之间存在显著关联（<0.001）。具体而言，神经外科患者入住护理酒店的可能性更高[比值比（OR）=1.86，=0.004]，耳鼻喉科患者（OR=2.70，<0.001）以及普通外科患者（OR=2.75，=0.002）也是如此。此外，行程超过110英里的患者入住护理酒店的可能性更高[OR（每增加一倍）=1.10，=0.007]。
在为门诊手术后的患者制定术后护理模式时，为确保患者接受，转诊手术科室是需要考虑的主要因素之一，同时还要考虑患者的距离。本研究可为其他考虑采用这种模式的医疗机构提供帮助，因为它提供了哪些因素最能表明患者接受程度的指导。
