| Title |
The Effect of Hospital Isolation Precautions on Patient Outcomes and Cost of Care: A Multi-Site, Retrospective, Propensity Score-Matched Cohort Study
|
|---|---|
| Published in |
Journal of General Internal Medicine, October 2016
|
| DOI | 10.1007/s11606-016-3862-4 |
| Pubmed ID | |
| Authors |
Kim Tran, Chaim Bell, Nathan Stall, George Tomlinson, Allison McGeer, Andrew Morris, Michael Gardam, Howard B. Abrams |
| Abstract |
Isolation precautions have negative effects on patient safety, psychological well-being, and healthcare worker contact. However, it is not known whether isolation precautions affect certain hospital-related outcomes. To examine the effect of isolation precautions on hospital-related outcomes and cost of care. Retrospective, propensity-score matched cohort study of inpatients admitted to general internal medicine (GIM) services at three academic hospitals in Toronto, Ontario, Canada between January 2010 and December 2012. Adult (≥18 years of age) patients on isolation precautions for respiratory illnesses and methicillin-resistant Staphylococcus aureus (MRSA) were matched to controls based on propensity scores derived from nine covariates: age, sex, Resource Intensity Weight, number of hospital readmissions within 90 days, total length of stay for hospital admissions within 90 days, site of admission, month of isolation, year of isolation, and Case Mix Group. Thirty-day readmission rates and emergency department visits, hospital length of stay, expected length of stay, adverse events, in-hospital mortality, patient complaints, and cost of care in Canadian doll ars (CAD). A total of 17,649 non-isolated patients were admitted to the participating hospitals during the study period. We identified 1506 patients isolated for respiratory illnesses and 745 patients isolated for MRSA. Compared to non-isolated individuals, those on isolation precautions for respiratory illnesses stayed 17 % longer (95 % CI: 9 %, 25 %), stayed 9 % longer than expected (95 % CI: 3 %, 15 %), and had 23 % higher cost of care (95 % CI: 14 %, 32 %). Patients isolated for MRSA had similar outcomes, but they also had a 4.4 % higher (95 % CI: 1.4 %, 7.3 %) rate of readmission to hospital within 30 days. Isolation precautions are associated with adverse effects which may result in poorer hospital outcomes. Balancing the benefits for the many with the harms to the few will be a future challenge. |
X Demographics
The data shown below were collected from the profiles of 28 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 10 | 36% |
| United Kingdom | 5 | 18% |
| Spain | 4 | 14% |
| Mexico | 1 | 4% |
| Canada | 1 | 4% |
| Unknown | 7 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 15 | 54% |
| Practitioners (doctors, other healthcare professionals) | 7 | 25% |
| Science communicators (journalists, bloggers, editors) | 3 | 11% |
| Scientists | 3 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 135 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | <1% |
| Unknown | 134 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 20 | 15% |
| Researcher | 16 | 12% |
| Student > Bachelor | 15 | 11% |
| Other | 12 | 9% |
| Student > Ph. D. Student | 8 | 6% |
| Other | 25 | 19% |
| Unknown | 39 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 34 | 25% |
| Nursing and Health Professions | 24 | 18% |
| Agricultural and Biological Sciences | 7 | 5% |
| Psychology | 4 | 3% |
| Environmental Science | 3 | 2% |
| Other | 21 | 16% |
| Unknown | 42 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 28. 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 13 January 2022.
All research outputs
#1,392,019
of 25,529,543 outputs
Outputs from Journal of General Internal Medicine
#1,099
of 8,213 outputs
Outputs of similar age
#24,890
of 323,456 outputs
Outputs of similar age from Journal of General Internal Medicine
#16
of 81 outputs
Altmetric has tracked 25,529,543 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,213 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.1. This one has done well, scoring higher than 86% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 323,456 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 81 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 81% of its contemporaries.