Article Figures & Tables
Figures
- Figure 1
Trends in resource use in general internal medicine between Apr. 1, 2010, and Mar. 31, 2015. *Readmission to general internal medicine at 1 of the participating hospitals within 30 days of discharge. †Proportion of patients who received at least 1 ultrasound examination, computed tomography scan or magnetic resonance imaging scan, as an indicator of the intensity of investigations patients received.
Tables
- Table 1: Characteristics of hospital admissions in the General Medicine Inpatient Initiative study cohort
Characteristic No. (%) of admissions*
n = 136 208Age, median (IQR), yr 73 (57-84) Age group, yr < 60 39 004 (28.6) 60-80 46 039 (33.8) > 80 51 165 (37.6) Female sex 68 971 (50.6) No. of comorbidities, median (IQR) 6 (3-9) Charlson Comorbidity Index score 0 58 257 (42.8) 1 20 620 (15.1) ≥ 2 57 331 (42.1) Most common comorbid conditions Hypertension 51 204 (37.6) Type 2 diabetes mellitus 45 376 (33.3) Atrial fibrillation and flutter 19 947 (14.6) Dyslipidemia 19 518 (14.3) Electrolyte abnormality 19 113 (14.0) Heart failure 18 736 (13.8) Discharge disposition Home 96 414 (70.8) Nursing home or rehabilitation facility 25 804 (18.9) Death 8916 (6.5) Discharge against medical advice 2543 (1.9) Other acute care hospital 1841 (1.4) Other 690 (0.5) Note: IQR = interquartile range.
*Except where noted otherwise.
- Table 2: Characteristics of hospital admissions and outcomes among most prevalent conditions in general internal medicine*
Characteristic Condition; no. (%) of admissions† Total cohort
n = 136 208Pneumonia
n = 6804Heart failure
n = 6341Chronic obstructive pulmonary disease
n = 5574Urinary tract infection
n = 5466Stroke
n = 4912Age, median (IQR), yr 73 (57-84) 80 (64-87) 83 (75-88) 77 (66-84) 80 (69-87) 76 (64-84) Comorbidities, median (IQR) 6 (3-9) 5 (3-8) 7 (5-10) 6 (3-8) 6 (4-9) 5 (3-7) Intensive care unit use‡ 10 031 (9.9) 460 (8.6) 409 (8.0) 589 (12.6) 185 (5.3) 337 (14.5) Death in hospital 8916 (6.5) 534 (7.8) 491 (7.7) 293 (5.3) 150 (2.7) 410 (8.3) 30-day readmission§ 14 387 (10.9) 620 (9.4) 990 (16.1) 893 (16.5) 663 (12.4) 268 (5.7) Note: IQR = interquartile range.
*Identified with the use of Canadian Institute for Health Information case-mix groups.
†Except where noted otherwise.
‡Intensive care or step-up unit. Does not include data for 34 453 patients at Trillium Health Partners (data not available at the time of submission).
§Readmission to general internal medicine service at 1 of the participating hospitals within 30 days of discharge. Patients with no health insurance number could not be linked across admissions and were excluded from this calculation, as were patients discharged within the last 30 days of the study.
Resource Total cohort Pneumonia Heart failure Chronic obstructive pulmonary disease Urinary tract infection Stroke Cost, median (IQR), $* 5850
(3915-10 061)5935
(4343-8068)6706
(4956-9403)6148
(4459-8741)5391
(3981-7140)6915
(5584-11 455)Length of stay, median (IQR), d 4.6 (2.5-8.6) 4.5 (2.5-7.7) 5.6 (3.1-9.7) 4.4 (2.5-7.5) 4.4 (2.7-6.9) 6.4 (3.9-10.4) Bed-days, no. (% of total for cohort) 1 310 717 (100.0) 50 059 (3.8) 56 799 (4.3) 39 159 (3.0) 39 552 (3.0) 64 550 (4.9) Alternate level of care designation, no. (%) of admissions 16 868 (12.4) 567 (8.3) 614 (9.7) 434 (7.8) 609 (11.1) 1197 (24.4) Alternate level of care days, no. (% of total alternate level of care days) 288 250 (100.0) 6713 (2.3) 7585 (2.6) 4949 (1.7) 7531 (2.6) 19 075 (6.6) Note: IQR = interquartile range.
*Forty-eight admissions with missing cost data were excluded.
- Table 4: Use of diagnostic and therapeutic services among most prevalent conditions in general internal medicine
Service Condition; no. (%) of admissions* Total cohort Pneumonia Heart failure Chronic obstructive pulmonary disease Urinary tract infection Stroke Radiography† 84 481 (83.0) 5242 (98.5) 5040 (99.0) 4592 (98.5) 3069 (87.7) 1562 (67.1) Computed tomography† 53 125 (52.2) 2327 (43.7) 1459 (28.6) 1571 (33.7) 1631 (46.6) 2265 (97.3) Ultrasonography† 28 893 (28.4) 985 (18.5) 1606 (31.5) 777 (16.7) 1261 (36.0) 841 (36.1) Magnetic resonance imaging† 11 649 (11.4) 118 (2.2) 72 (1.4) 55 (1.2) 131 (3.7) 1512 (64.9) Interventional radiology† 10 778 (10.6) 259 (4.9) 201 (3.9) 141 (3.0) 322 (9.2) 150 (6.4) Erythrocyte transfusion† 9325 (9.2) 213 (4.0) 243 (4.8) 105 (2.3) 114 (3.3) 55 (2.4) Endoscopy/bronchoscopy 13 832 (10.2) 360 (5.3) 169 (2.7) 182 (3.3) 101 (1.8) 139 (2.8) Dialysis 2448 (1.8) 130 (1.9) 91 (1.4) 44 (0.8) 41 (0.8) 36 (0.7) *Number of admissions with at least 1 of this test or treatment.
†Data not available for 34 453 patients at Trillium Health Partners.
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