Allam Samy
Quality and Health Data Integrity, Arrowhead Regional Medical Center, Colton, USA.
Medical Education, California University of Science and Medicine, Colton, USA.
Cureus. 2024 Dec 25;16(12):e76370. doi: 10.7759/cureus.76370. eCollection 2024 Dec.
Introduction The patient-centered care model emphasizes patient autonomy in recovery, acknowledging each individual's unique journey. Despite challenges in the healthcare system, this model has gained traction nationwide. Advances in healthcare technology have highlighted obstacles to independent decision-making. This study addresses these issues by emphasizing the need for consistent access to health information, which is crucial for empowering patients. We aim to proactively identify information gaps and propose new insights for better data precision and synchronization protocols. Our analysis of nationwide hospital length of stay (LOS) data demonstrates data-driven interventions tailored to patients' needs, aiming to improve the hospital experience and reduce care fragmentation. Methods We examined the complex nature of hospital LOS and various variables across nationwide healthcare settings using CMS data from 2011 to 2021. To enhance our national findings, we incorporated a local perspective by analyzing LOS data from Arrowhead Regional Medical Center (ARMC) and its associated diagnosis-related groups (DRGs). We employed a propensity score to adjust for variables and proactively drive realistic predictions of hospital outcomes. This methodological approach emphasizes the importance of using tools that can be scaled from localized settings to a broader national context. Furthermore, our study highlights the critical need for continuous quality assessment of hospital LOS. This includes measuring LOS and developing innovative tools capable of predicting, analyzing, intervening, and prompting actions based on insights gained from data analysis. The study aims to achieve several core objectives by integrating these components: enhancing patient empowerment through improved communication, refining LOS assessment through innovative techniques, and developing predictive tools to inform clinical practice and policy. Ultimately, this research contributes to a more patient-centered approach to managing inpatient care, improving patient outcomes and satisfaction. Results Our study aspires to transform three pivotal domains that can enhance patient autonomy, optimize hospital recovery, and elevate the overall experience. First, the cost of care reveals that prolonged hospital stays and escalating expenses are often linked to more severe health consequences. Second, our analysis uncovers the intricate relationship between hospital outcomes, such as mortality and readmissions, showing that shorter hospital stays can diminish patients' risk of complications. However, we must tread carefully, as this approach may lead to premature discharges. Lastly, providers can gain more precise insights into these interconnected outcomes by leveraging data tools such as propensity scores. We advocate for the dissolution of care fragmentation through robust health information exchange (HIE), and the adoption of innovative strategies such as blockchain and advanced machine learning (ML) techniques that rise to contemporary medicine and adapt to the growing patient needs.
引言 以患者为中心的护理模式强调患者在康复过程中的自主性,承认每个人的康复历程都是独特的。尽管医疗系统存在挑战,但该模式已在全国范围内得到推广。医疗技术的进步凸显了独立决策的障碍。本研究通过强调持续获取健康信息的必要性来解决这些问题,这对增强患者权能至关重要。我们旨在主动识别信息差距,并提出新的见解,以提高数据精度和同步协议。我们对全国医院住院时长(LOS)数据的分析展示了根据患者需求定制的数据驱动型干预措施,旨在改善医院体验并减少护理碎片化。
方法 我们使用2011年至2021年的医疗保险和医疗补助服务中心(CMS)数据,研究了全国医疗环境中医院住院时长的复杂性质以及各种变量。为了强化我们的全国性研究结果,我们通过分析箭头区域医疗中心(ARMC)及其相关诊断相关分组(DRG)的住院时长数据纳入了地方视角。我们采用倾向得分来调整变量,并积极推动对医院结局的现实预测。这种方法强调了使用可从局部环境扩展到更广泛全国背景的工具的重要性。此外,我们的研究突出了对医院住院时长进行持续质量评估的迫切需求。这包括测量住院时长以及开发能够基于数据分析得出的见解进行预测、分析、干预和促进行动的创新工具。该研究旨在通过整合这些要素实现几个核心目标:通过改善沟通增强患者权能,通过创新技术优化住院时长评估,以及开发预测工具以指导临床实践和政策制定。最终,这项研究有助于形成一种更以患者为中心的住院护理管理方法,改善患者结局和满意度。
结果 我们的研究致力于改变三个关键领域,这些领域可以增强患者自主性、优化医院康复并提升整体体验。首先,护理成本表明,住院时间延长和费用增加往往与更严重的健康后果相关。其次,我们的分析揭示了医院结局(如死亡率和再入院率)之间的复杂关系,表明住院时间缩短可以降低患者出现并发症的风险。然而,我们必须谨慎行事,因为这种方法可能导致过早出院。最后,提供者可以通过利用倾向得分等数据工具更精确地洞察这些相互关联的结局。我们主张通过强大的健康信息交换(HIE)消除护理碎片化,并采用区块链和先进机器学习(ML)技术等创新策略,以跟上当代医学的步伐并适应不断增长的患者需求。