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The ethics of caring for hospital-dependent patients

Overview of attention for article published in BMC Medical Ethics, December 2017
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  • Good Attention Score compared to outputs of the same age (65th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

twitter
6 tweeters
facebook
1 Facebook page

Readers on

mendeley
34 Mendeley
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Title
The ethics of caring for hospital-dependent patients
Published in
BMC Medical Ethics, December 2017
DOI 10.1186/s12910-017-0238-1
Pubmed ID
Authors

Calvin Sung, Jennifer L. Herbst

Abstract

Hospital-dependent patients are individuals who are repeatedly readmitted to the hospital because their acute medical needs cannot be met elsewhere. Unlike the chronically critically ill, these patients do not have a continuous need for life-sustaining equipment and can experience periods of relative stability where they have a good quality of life. However, some end up spending months or even years in the hospital receiving resource-intensive care because they are unable to be safely discharged, despite an initial optimistic prognosis. It is hard to reliably identify these patients on admission and more research is needed to better understand the unique medical needs of this population. But the inability to safely discharge these patients to their home or to a skilled nursing facility without rapid readmissions also creates ethical implications for the physicians who care for them. The aim of this paper is to clarify some of the ethical considerations involved in caring for hospital-dependent patients. Among physicians, the care of hospital-dependent patients is likely to disproportionately affect hospitalists and intensivists, whose care is often evaluated in terms of reducing patient length of stay and readmissions. Because hospital-dependent patients' medical needs thwart the traditional goal of safe discharge, both clinical ethics and physicians' professional obligations are implicated by their care. The inability to reliably identify these patients early can complicate discussions about treatment goals and informed consent. Similarly, the tremendous dedication of limited resources to these patients without safe discharge back to the community may raise concerns about the just allocation of healthcare resources. Our current acute care hospitals are not designed to provide long-term care for hospital-dependent patients. Unfortunately, safe discharge options remain elusive for these patients. Further research and support of this population is needed to more reliably identify hospital-dependent patients on admission, better inform the discussions of short- and long-term treatment goals, and more wisely allocate resources both within our acute care hospitals and larger healthcare system.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters 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 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 18%
Lecturer 3 9%
Student > Doctoral Student 3 9%
Student > Ph. D. Student 3 9%
Student > Bachelor 3 9%
Other 9 26%
Unknown 7 21%
Readers by discipline Count As %
Medicine and Dentistry 12 35%
Nursing and Health Professions 6 18%
Social Sciences 3 9%
Computer Science 1 3%
Agricultural and Biological Sciences 1 3%
Other 3 9%
Unknown 8 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. 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 15 August 2018.
All research outputs
#4,012,675
of 13,801,769 outputs
Outputs from BMC Medical Ethics
#355
of 594 outputs
Outputs of similar age
#133,718
of 395,510 outputs
Outputs of similar age from BMC Medical Ethics
#47
of 69 outputs
Altmetric has tracked 13,801,769 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 594 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.1. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
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 395,510 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.
We're also able to compare this research output to 69 others from the same source and published within six weeks on either side of this one. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.