Quality of care and outcomes in internal medicine patients bedspaced to noninternal medicine units

Hospital overcrowding has led to a practice known as bedspacing (in which admitted patients are placed on a different specialty's inpatient ward), yet little is known about the impact of this practice on healthcare quality.We investigated whether hospital outcome measures differ between bedspac...

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Bibliographic Details
Published in:Medicine (Baltimore) 2021-05, Vol.100 (18), p.e25737-e25737
Main Authors: Bogler, Orly, Liu, Jessica, Cadesky, Ben, Bell, Chaim M.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Female
Hospital Bed Capacity - statistics & numerical data
Hospital Mortality
Hospitals, University - organization & administration
Hospitals, University - statistics & numerical data
Humans
Internal Medicine - organization & administration
Internal Medicine - statistics & numerical data
Length of Stay - statistics & numerical data
Male
Middle Aged
Observational Study
Ontario - epidemiology
Patient Admission - statistics & numerical data
Patient Readmission - statistics & numerical data
Quality of Health Care - statistics & numerical data
Retrospective Studies
Tertiary Care Centers - organization & administration
Tertiary Care Centers - statistics & numerical data
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Summary:Hospital overcrowding has led to a practice known as bedspacing (in which admitted patients are placed on a different specialty's inpatient ward), yet little is known about the impact of this practice on healthcare quality.We investigated whether hospital outcome measures differ between bedspaced general internal medicine (GIM) patients vs nonbedspaced patients.Our retrospective study included patients admitted to GIM wards at 2 academic hospitals (2012-2014), comparing bedspaced to nonbedspaced patients, and identifying adverse events from the hospital's Electronic Patient Record.We compared these groups with respect to actual length of stay vs the expected length of stay (% ELOS), which is defined as length of stay (LOS) divided by expected length of stay (ELOS), 30-day readmission, adverse events (falls, medication-related incidents, equipment-related incidents, first treatment related incidents, laboratory-related incidents, and operative/invasive events), and in-hospital mortality.There were 22,519 patients analyzed with 15,985 (71%) discharged from a medical ward and 6534 (29%) discharged from a non-medical ward. Bedspaced patients had shorter lengths of stay (4.1 vs 6.2 days, P 
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000025737