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Outcomes associated with observation versus short-stay admission among chest pain patients in the Veterans Health Administration

Overview of attention for article published in BMC Emergency Medicine, September 2016
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Title
Outcomes associated with observation versus short-stay admission among chest pain patients in the Veterans Health Administration
Published in
BMC Emergency Medicine, September 2016
DOI 10.1186/s12873-016-0103-4
Pubmed ID
Authors

Brad Wright, Amy M. J. O’Shea, Justin M. Glasgow, Padmaja Ayyagari, Mary Vaughan-Sarrazin

Abstract

To determine the extent to which 30- and 90-day hospital readmission and mortality rates differ as a function of whether a chest pain patient is placed in observation status or admitted to the hospital for a short-stay (<48 h). Using 114,043 observation stays and short-stay admissions for chest pain at Veterans Health Administration hospitals between 2005 and 2013, we estimated event-level logistic regression models using a generalized estimating equation framework to predict 30 and 90-day readmissions and mortality as a function of whether the patient had an observation stay or a short-stay admission. We also adjusted for a variety of patient characteristics and unobserved time-invariant hospital factors. Relative to the short-stay inpatient group, veterans with chest pain who were placed in observation status were significantly more likely to be female (7.0 % vs. 6.4 %, White (76.6 % vs. 71.0 %, and from a rural area (28.3 % vs. 20.2 %). There were no other meaningful differences between the groups. Veterans with chest pain who were placed in observation status had 25 % lower odds of dying within 30 days (95 % confidence interval [CI]: 3 % - 43 %) and 12 % lower odds of a 30-day readmission (95 % CI: 6 % - 17 %) compared to those admitted as short-stay inpatients. Neither 90-day outcome was significantly associated with placement in observation status. Patient demographics were also important predictors of mortality and readmissions. There are clinically observable differences in outcomes between patients admitted to observation and those admitted as short-stay inpatients. We find no evidence that the increase in observation stays reflects a lack of proper care for patients placed in observation status.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 14 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 14 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 21%
Student > Master 3 21%
Other 2 14%
Student > Bachelor 1 7%
Student > Doctoral Student 1 7%
Other 2 14%
Unknown 2 14%
Readers by discipline Count As %
Medicine and Dentistry 6 43%
Psychology 1 7%
Economics, Econometrics and Finance 1 7%
Social Sciences 1 7%
Arts and Humanities 1 7%
Other 1 7%
Unknown 3 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 October 2016.
All research outputs
#7,311,206
of 8,461,697 outputs
Outputs from BMC Emergency Medicine
#215
of 231 outputs
Outputs of similar age
#209,341
of 254,160 outputs
Outputs of similar age from BMC Emergency Medicine
#10
of 11 outputs
Altmetric has tracked 8,461,697 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 231 research outputs from this source. They receive a mean Attention Score of 4.9. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 11 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.