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

• 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
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000025737

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