Hospital Beds Research Articles

Outpatient parenteral antibiotic treatment for infective endocarditis: A retrospective observational evaluation

BackgroundInfective endocarditis (IE) requires long courses of intravenous (IV) antibiotics. Outpatient parenteral antibiotic therapy (OPAT) saves resources, improves the patient experience and allows care in their preferred place; however, questions remain about safety when treating IE patients. This study evaluates OPAT management of IE patients in our region between 2006 and 2019. MethodsThis is a retrospective observational evaluation and description of outcomes and adherence to suitability criteria, according to British Society for Antimicrobial Chemotherapy (BSAC) guidelines. ResultsWe identified five models of OPAT delivery. The number of patients treated expanded significantly over time. Of 101 patients, six (6%) suffered poor outcomes, but each patient had contributing factors outside of the primary infection. Median OPAT duration was 12 days and 1,489 hospital bed days were saved. ConclusionsIn a setting where there was good adherence to BSAC criteria, treating IE patients using OPAT services was safe. Complications observed were likely independent of treatment location. Significant bed days were saved.

Impact of an ICU bed capacity optimisation method on the average length of stay and average cost of hospitalisation following implementation of China’s open policy with respect to COVID-19: a difference-in-differences analysis based on information management system data from a tertiary hospital in southwest China

ObjectivesFollowing the implementation of China’s open policy with respect to COVID-19 on 7 December 2022, the influx of patients with infectious diseases has surged rapidly, necessitating hospitals to adopt temporary...

An Adaptive Research Approach to COVID-19 Forecasting for Regional Health Systems in England

A team of researchers worked with public health officials and clinical decision makers to create real-time models to help predict COVID-19 cases and hospital bed needs in the East of England. These models used up-to-date data and allowed officials to explore different scenarios and make informed plans. The models have also been applied in other countries and can be a valuable tool in future epidemics.

Antimicrobial prescribing in acute pancreatitis: Too much for too many?

BackgroundAcute pancreatitis (AP) is an inflammatory condition of the pancreas that varies widely in both clinical presentation and severity. Current international guidelines do not recommend the use of prophylactic antimicrobials in AP. AimTo review the compliance of antimicrobial prescribing in AP with international guidelines. MethodWe conducted a retrospective review of patients admitted with AP between 1st January 2021 and 31st December 2021, in Beaumont Hospital, Dublin, Ireland. For each case identified, the 2012 Revised Atlanta Criteria for AP were then applied on review of medical, laboratory and radiology records. ResultsThere were 98 patients, 52 % male (n = 51) with a median age of 53 years (range 18–88) who met the Revised Atlanta Criteria accounting for 1,032 hospital bed days inclusive of 82 critical care bed days. Gallstones were the most common aetiology; 48 % (n = 47). Antimicrobials were prescribed for 55 (56 %) patients with AP. Of those, only 38 % (n = 21) met the American Gastroenterological Association criteria for antimicrobials. The most common classes of antimicrobials prescribed were beta-lactams and carbapenems. Procalcitonin testing was conducted on just one patient (1 %). There were no cases of inpatient or 90-day mortality. ConclusionsOur findings are consistent with previously published reports of low mortality in mild acute AP and an excessive prescription of antimicrobials, highlighting this as an area for a targeted antimicrobial stewardship (AMS) intervention, including an increased use of procalcitonin as a biomarker.

Incidents et accidents médicamenteux en établissement de santé : une analyse descriptive au sein d’un CHU mère-enfant de 2018 à 2022

The safety of care provided is based on an analysis of medication incidents and accidents. The primary objective was to describe medication-related incidents and accidents (I&A) within a university-affiliated hospital. This retrospective descriptive study was based on data from a 500-bed mother-child university-affiliated hospital. All I&As declared between April 1, 2018, and March 31, 2022, were considered. The analysis included all medication-related I&As that occurred during an admission or in an outpatient setting. Some variables were recoded manually. Descriptive statistical analyses were performed. A total of 23 284 I&As were considered, including 7578 medication-related I&As. Daily averages of 15.9 ± 14.0 I&As and 5.2 ± 0.3 medication-related I&As were reported. There were 22.4 medication-related I&As/1000 inpatient days. The majority of medication-related I&As occurred in surgery (20%, 1530/7578), oncology (19%, 1405/7578), and pediatrics (16%, 1200/7578). Most were associated with incorrect dosing (21%, 1575/7578); infiltration, extravasation, or removed lines (19%, 1405/7578); and omissions (16%, 1205/7578). Physical consequences were reported in 15% (1158/7578) of the medication-related I&As. Conversely, psychological consequences were reported in less than 1% (44/7578) of medication-related I&As. This study provides a comprehensive descriptive profile over a 4-year period. Most of the reported I&As did not lead to consequences for patients. The sharing of ratios promotes comparative analysis with other facilities and can contribute to discussions about risk reduction. A culture of reporting events is present within this health care facility.

Impact on Hospital Resource Utilization of Endoluminal Bypass Using the Viabahn Endoprosthesis with Heparin Bioactive Surface Compared With Surgical Femoropopliteal Bypass.

To assess the impact of heparin-bonded endoprosthesis compared with femoropopliteal bypass on key hospital resources and revenues up to 1-year follow-up. A 2-arm scenario resource consumption data analysis was modeled based on a multicentre prospective randomized controlled trial. Six centers in the Netherlands. A total of 100 patients were assigned to 2 arms (50 each arm). The first arm evaluated endovascular treatment using the heparin-bonded Viabahn endoprosthesis and the second the femoropopliteal bypass. Resource consumption rates were compared between arms. Resource consumption rates, including hospital stay for bypass procedure, operating room time, type of anesthesia, number of used (endo)grafts, use of different types of bed locations (vascular ward, medium or intensive care), readmission for wound infections, and reinterventions over a period of 12 months. Endovascular repair used fewer hospital resources, with an overall difference of €149.983. Hospital stay was 118 days less (261 vs 379), including 21 fewer days in medium/intensive care (5 vs 26) and 50 fewer operating room hours (100 vs 150). Fewer patients required general anesthesia (31 vs 39), and there were less surgical site infections (3 vs 12). In the surgical bypass group, there were 18 fewer days of hospital stay related to reinterventions (80 vs 62), and the cost of the devices was €309.996, cheaper. The total monetary difference was € 160.013, in favor of the femoropopliteal bypass (€3.200, per patient). Endovascular repair of the superficial femoral artery reduces the use of valuable hospital resources. Its major limitation is the cost of the devices, which should be balanced against the reduction in peri-procedural morbidity and faster recovery. In the context of shortage of hospital beds, it offers capacity benefits, allowing for the treatment of more patients overall. These benefits may outweigh the fewer reinterventions in the surgical bypass group. The SuperB Trial was registered in clinicaltrials.gov; NCT-ID: NCT01220245. Modeling is a useful technique to predict the impact of treatment modalities on hospital resources and revenue. This study uses real-world data from the SuperB Trial to compare two treatment strategies of superficial femoral artery disease, reflecting actual clinical practice and patient outcomes. The analysis focused on direct costs associated with hospital resources and device usage without considering indirect costs or long-term cost-effectiveness. The analysis showed that endovascular repair reduces the use of valuable hospital resources. Its major limitation is device costs, which should be balanced against the reduction in peri-procedural morbidity and faster recovery. In the context of shortage of hospital beds, it offers capacity benefits, allowing for the treatment of more patients overall.

Low Cost Motorized Patient BED with Voice Control

In recent years, there has been a growing interest in integrating advanced technologies into healthcare settings to improve patient care and enhance medical infrastructure. One such innovation is the motorized voice-controlled hospital bed, which represents a significant advancement in patient comfort, mobility, and overall healthcare management. This paper presents the design, development, and implementation of a motorized voice- controlled hospital bed aimed at revolutionizing patient care in medical facilities. The motorized voice-controlled hospital bed incorporates cutting- edge technology, including voice recognition systems, motorized actuators, and wireless connectivity. Through voice commands, patients can effortlessly adjust the bed's position, including height, tilt, and backrest angle, enhancing their comfort and facilitating activities such as eating, reading, and watching television. Moreover, healthcare providers can remotely monitor and adjust bed settings, ensuring optimal patient positioning and reducing the risk of complications such as pressure ulcers. Key features of the motorized voice-controlled hospital bed include an intuitive voice interface, customization positioning options, safety mechanisms to prevent unintended movements, and seamless integration with existing healthcare infrastructure. Additionally, the bed's design prioritizes patient safety, infection control, and ease of maintenance, adhering to stringent healthcare standards and regulations.

Implementing policies and predictive stochastic models to restrict borderline personality disorder’s access to restricted medications: comorbidity with factitious disorder, functional neurological disorder and medically unexplained symptoms

IntroductionWe are facing increased access to hospital beds and increased use of restricted medications by people with borderline personality disorder (BPD). Our former research shows BPD comorbidity with factitious conditions, functional neurological disorder and medically unexplained symptoms. We also registered that persons with BPD might craft or exaggerate symptoms to access restricted medications. In the worst cases, they might share these medications (benzodiazepines, hypnotics, and anxiolytics) with street values for profit or other recreational purposes.ObjectivesTo generate forecasting models and preventive policies to deal with BPD factitious disorders and improve the effectiveness of the UK National Healthcare Service (NHS) in reducing unnecessary admissions to general and psychiatric hospitals. More selective policies will capture and discourage BPD’s feigning and exaggerating symptoms for accessing restricted medications.MethodsThe underlying analysis framework is stochastic forecasting. We used current knowledge and data to complete systematic future predictions extracted from recent trends. A logical-mathematical model generated the required expressions. We identify four major model components to be introduced in the model: BPD (A), factious disorders (B), prescribing restricted medications (C), antisocial behaviours (D), and access to hospital beds (E).ResultsThe Boolean expression becomes [A then B then C then D then E], or [A ⇒ (B ⇒ (C ⇒ (D ⇒ E))] with a truth density of 96.875% (Figure 1).ConclusionsBPD should alert healthcare of the risks of symptom exaggeration and factitious mental diseases. These conditions are used to access often restricted medications, such as benzodiazepines, sleep tablets, and anxiolytics, for personal and communal use. Street sharing of these last increases local criminality. In worst cases, a hospital bed is granted without preventive triage. The risk is the indoor access to these medications. We advocate policies for the discontinuation of community prescription of these drugs.Disclosure of InterestNone Declared

The development of a delirium and dementia outreach team in a district general hospital

The structure of NHS services nationally means that there is enormous variation in the availability and content of specialist dementia and delirium services to patients in acute hospitals. The Dementia Action Alliance estimate that over 25% of beds in acute hospitals are occupied by people with dementia and their stays are longer with difficulties discharging in a timely way. 42% of unplanned admissions are people over 70 with dementia and there are high re-admission rates. The NIHR report by Gwernan-Jones et al. (2020) emphasises the need for a transformation of organisational and ward culture to improve the experience of people with dementia in hospital. For Warwick Hospital, a district general in the South Warwickshire NHS Foundation Trust (SWFT) there is enormous pressure for beds and an emphasis on flow through the hospital, including a need to reduce acute admissions and shorten length of stay. A pilot project was developed to seek to review the current data on patients with dementia in hospital, consider the assessment and interventions for delirium and advise on interventions that could both improve patient care and influence discharge. The initial findings for the project are shared alongside a review of the psychology role and challenges faced.

Predicting pressure injury risk in hospitalised patients using machine learning with electronic health records: a US multilevel cohort study

ObjectiveTo predict the risk of hospital-acquired pressure injury using machine learning compared with standard care.DesignWe obtained electronic health records (EHRs) to structure a multilevel cohort of hospitalised patients at risk...

Equity in distribution of hospital beds in Tehran province

Equity in distribution of hospital beds in Tehran province

Empiètement, rejet ou tempérance : l’adolescence en pédiatrie au risque de la surviolence

ContextThe work of the clinical psychologist in pediatric hospitals aims to promote the subjective appropriation of the experience by the child, by ensuring a feeling of continuity and security. It is particularly important to ensure the quality of the relation between subject, entourage, and caregivers. However, a certain amount of violence exists in the relation between caregiver and patient. We suggest that beyond the violence of caregiving itself, there is an “over-violence” (Tomkiewicz, 1991) which risks undermining the patient's feeling of security. ObjectivesWe believe that this over-violence arises when caregivers are confronted with intolerable experiences in the face of the vital risk incurred by the patient. This article aims to examine the emergence of this over-violence and its modes of expression. MethodThis work is based on several situations encountered in different pediatric wards, based on three cases of adolescent patients who put their caregivers in difficulty and required the intervention of hospital psychologists to understand the issues at hand. ResultsThrough these different clinical cases we identify two mechanisms of over-violence. First, encroachment, in the form of excessive control of patients’ behavior, which echoes the control that exists over the bodies of sick children. second, rejection, as an attempt to evacuate that which is violent, despite the needs of the patient, sometimes justified by the imperative of freeing hospital beds for other patients. We also identify the effects of a paradoxical over-violence in the oscillation between these two poles. DiscussionFaced with potential death and the anxiety it arouses, caregivers confronted with violent affects deploy unconscious defense mechanisms that can undermine the professional-patient relationship and can produce over-violence in care. Faced with this phenomenon, reflecting together as a team allows for the regulation of affects and promotes temperance in the professional-patient relationship. Psychologists practicing in somatic hospitals are instrumental in the setting up and maintaining of spaces for regulation or analysis of professional practice in services in which psychological care is not the primary task.

A fair bed allocation during COVID-19 pandemic using TOPSIS technique based on correlation coefficient for interval-valued pythagorean fuzzy hypersoft set

The relationship between two variables is an essential factor in statistics, and the accuracy of the results depends on the data collected. However, the data collected for statistical analysis can be unclear and difficult to interpret. One way to predict how one variable will change about another is by using the correlation coefficient (CC), but this method is not commonly used in interval-valued Pythagorean fuzzy hypersoft set (IVPFHSS). The IVPFHSS is a more advanced and generalized form of the Pythagorean fuzzy hypersoft set (PFHSS), which allows for more precise and accurate analysis. In this research, we introduce the correlation coefficient (CC) and weighted correlation coefficient (WCC) for IVPFHSS and their essential properties. To demonstrate the applicability of these measures, we use the COVID-19 pandemic as an example and establish a prioritization technique for order preference by similarity to the ideal solution (TOPSIS) model. The technique is used to study the problem of optimizing the allocation of hospital beds during the pandemic. This study provides insights into the importance of utilizing correlation measures for decision-making in uncertain and complex situations like the COVID-19 pandemic. It is a robust multi-attribute decision-making (MADM) methodology with significant importance. Subsequently, it is planned to increase a dynamic bed allocation algorithm based on biogeography to accomplish the superlative decision-making system. Moreover, numerical investigations deliberate the best decision structures and deliver sensitivity analyses. The efficiency of our encouraged algorithm is more consistent than prevalent models, and it can effectively control and determine the optimal configurations for the study.

Deinstitutionalization in Georgia-why it is so slow

IntroductionMental health reform represents one of the most transformative changes in the field of healthcare, as it not only changes the forms of services but also the nature of services offered. While many countries have successfully implemented such reforms, others, including Georgia, have struggled with a protracted and inconsistent process. Despite decades of advocacy by professionals for deinstitutionalization and the development of community-based services, psychiatric hospital treatment continues to dominate in Georgia.ObjectivesThe purpose of the review is to explore the concept of deinstitutionalization within the mental health landscape and assess its status in the context of Georgia. It aims to study the lessons learned from successful deinstitutionalization and illuminate achievements and challenges surrounding deinstitutionalization in Georgia’s reality.MethodsA qualitative analysis including desk review, in-depth interviews and focus group discussions was conducted. Proceeding from the research objectives we analyzed the existing legislation, strategic documents and clinical practices concerning individuals with mental disorders; Interviews were also conducted with key informants on the shortcomings and problems in deinstitutionalization practicesResultsThe review findings reveal, that despite recent progress such as the development of community mobile teams and increased funding allocated for community services within mental health budget, several issues persist: there is no agreement among stakeholders on how to restructure existing hospital beds and financial provisions remain unresolved. The field of mental health in Georgia suffers from a lack of human resources. Attracting new personnel, ensuring regional distribution, and enhancing qualifications are necessary components of deinstitutionalization that require the involvement of all stakeholders, coordinated and time-planned action. The current mental healthcare system in Georgia is characterized by a lack of coordination and collaboration among its various components. Establishing patient care pathways with clear referral criteria is crucial for improving the efficiency of mental health services. This research highlights that successful deinstitutionalization requires additional funds, time, and trained people. Institutions should have a long-term (3-5) year development plan, detailing the source of funding, activities to be implemented, and expected outcomes. In the absence of such a plan, progress remains sporadic, intermittent, uncoordinated, and less effective.ConclusionsIn conclusion, the protracted nature of deinstitutionalization in Georgia requires a multifaceted approach involving various stakeholders. By addressing identified challenges and promoting coordination among mental health components, Georgia can guide a more effective course toward a community-based, patient-centered mental healthcare system.Disclosure of InterestNone Declared

193 Price Transparency and Cash Discounts for Implantable Pulse Generator Implantation in the United States

INTRODUCTION: Since the Healthcare PRICE Transparency Act (January 2021), hospitals are required to publicly disclose standard prices for care and procedures. METHODS: This is a cross-sectional study conducted with data obtained from Turquoise Health from January to April 2021. Current procedural terminology (CPT) code 61885 was used to query cases of DBS IPG connected to a single electrode. Inclusion criteria required reporting of both commercial and cash prices. Hospitals were filtered for cash to commercial price ratios <2. The Healthy Marketplace Index (HMI) was used to assess city-level hospital competition and the 2022 Lown Institute Hospital Index (LIHI) was used to assess hospital bed size. Differences in continuous variables were analyzed with a Kruskal-Wallis test. RESULTS: Eight-hundred forty-six centers met inclusion criteria, of which 98 (11.6%) provided commercial and cash prices and a cash to commercial ratio of <2. Of those 98, the median commercial price was $18,562 (IQR $1,572-28,476) and the median cash price was $4,340 ($1,596-27,223), with a median intrahospital cash to commercial price ratio of 0.78. Sixty-eight of those 98 (69.4%) hospitals provided a discount for cash payments (cash:commercial ratio<1) of 41% relative to commercial and 39% discount relative to Medicare prices (p<0.001). Medicaid prices significantly differed between hospital sizes. Univariate analysis demonstrated that hospital size and market share were not significant predictors of providing a fair cash estimate. Twenty-eight (56%) states provided a cash discount. CONCLUSIONS: Prices for IPG implantation varied greatly, with self-pay cash pricing providing significant discounts relative to commercial pricing. Cost data should be systematically analyzed and leveraged to increase cost awareness of the procedure, inform hospital reimbursements, and broaden patient accessibility to this valuable therapy.

Environmental sustainability in hospitals: Dual analysis of electrical consumption and pollutant emissions

The emission of pollutants following electricity consumption is significant, and hospitals are major contributors to energy consumption. Hence, the aim of this study was a survey of electrical consumption rate and environmental pollutants emissions in selected hospitals. This descriptive-analytical and cross-sectional study was conducted over three years and based on electricity bills and bed indicators in selected hospitals in Tehran, Iran. Emissions Calculator software was used to calculate the emission of pollutants caused by electricity consumption. Kolmogorov Smirnov, Least Significant Difference (LSD), and one-way ANOVA tests were used to analyze the data. Results showed that the total average electricity consumption for each active day bed and occupied day bed was 9.6 and 13.6 times higher than the recommended standards. The average electricity consumption for each active day bed in hospitals A, B, and C was 13.7, 10.2, and 5 times higher than the standard value, respectively, while for occupied day beds, the consumption was 17.3, 15.1, and 8.5 times higher than the standard value, respectively. Additionally, the total electricity consumption in these hospitals resulted in the emission of 41837100 kg of CO2, 124815 kg of SO2, 103699 kg of NOx, 9769 kg of CO, 4885 kg of PM10, and 757 kg of VOCs into the environment. Based on the monthly active bed index and occupied day bed, there was a significant difference in the average electrical consumption among A, B, and C hospitals (p = 0.0001). Electricity consumption in the studied hospitals exceeds standards. Implementing optimal designs for lighting, heating, and cooling, along with energy optimization training, technical audits, and inspections are essential for both economic benefits and reducing environmental pollutants.

Influenza-Associated Outcomes and Healthcare Utilization by Race and Ethnicity in the USA: a Retrospective Cohort Study Using the National Inpatient Sample Database.

The influenza virus continues to be a public health concern every season. We aimed to evaluate influenza-associated outcomes and healthcare utilization by race and ethnicity. We conducted a retrospective cohort study using the National Inpatient Sample across 2019 and 2020. Influenza pneumonia was selected as the principal diagnosis. Outcomes included mortality, use of respiratory support ventilation, length of stay, and total hospitalization charge. Regression models were adjusted for age, gender, Charlson Comorbidity Index, hospitals' region, bed size, teaching status, insurance status, and median income. We identified 73,098 individuals hospitalized with influenza pneumonia; 39,807 and 33,291 were admitted in 2019 and 2020, respectively. The sample included 49,829 (68%) White, 11,356 (15.5%) Black, 7526 (10%) Hispanic, 1860 (2.5%) Asian/Pacific, and 617 (0.84%) Native American patients. In-hospital mortality rates and respiratory support (non-invasive ventilation and invasive mechanical ventilation) in 2019 and 2020 were not significantly different across all the races. In 2019 and 2020, the adjusted odds ratios of in-patient mortality were not significantly different. Asians had higher odds of receiving NIV in 2019 but not in 2020 compared to White patients (adjusted odds ratio (aOR) 1.67, p value 0.04). The adjusted odds ratios for receiving IMV were not significantly different between the races in 2019 and 2020. This study contributes valuable insight into influenza-associated outcomes and healthcare utilization patterns among diverse racial and ethnic groups. Disparities in healthcare utilization were observed among younger (< 65years) individuals of Black and Hispanic ethnicity.

A 5-Year Review of a Tracheostomy Quality Improvement Initiative: Reducing Adverse Event Frequency and Severity.

The number of tracheostomies performed annually in resource-rich countries is estimated at 250,000. While an essential procedure, approximately 20% to 30% of patients will experience at least 1 tracheostomy-related adverse event. Within tracheostomy careand across wider health care environments, quality improvement (QI) programs have been shown to reduce patient harm and improve outcomes. Herein we report on a 5-year long, tracheostomy QI initiative aimed at improving patient experience and reducing the frequency and severity of adverse events. A 5-year (ongoing) QI initiative led by the Cardiff and Vale University Health Board tracheostomy team, within a tertiary, 1000-bedded hospital in South Wales, United Kingdom. The QI initiative has focused on 3 main themes: (1) Education and training; (2) Clinical oversight and decision making; and (3) improved data collection. Data were collected from existing tracheostomy databases. Over the past 5 years, we have observed a sustained reduction in both the frequency and severity of adverse events, with less than 1 patient per 100 experiencing a moderate or severe adverse event. This has resulted in improvements in patient experience and a cost reduction of £GBP364,726 per annum. Our 5-year ongoing tracheostomy QI initiative has resulted in improved outcomes with increased achievement of tracheostomy weaning markers and sustained reductions in both the frequency and severity of adverse events. A continuous focus on QI is associated with improved patient and service outcomes. These improvements can be spread and scaled to benefit more patients and organizations.

Effects of Aloe Gel on Lactating Women with Nipple Trauma.

Background: To investigate the efficacy of aloe gel in reducing pain and promoting wound healing in postpartum women with nipple trauma. Method: There were 80 postpartum women who took part in this study having developed nipple trauma during breastfeeding in the obstetrics department of a tertiary grade A hospital in Suzhou from January to December 2021. Postpartum women with nipple trauma whose hospital bed numbers ranged between 15 and 33 were included in the test group, whereas those whose hospital bed numbers ranged between 35 and 53 were included in the control group. Both groups received health education and breastfeeding guidance. The control group applied lanolin cream to their nipple trauma, whereas the test group used aloe gel. We used a nipple trauma severity assessment table to determine the severity of nipple trauma in lactating women and a Visual Analogue Scale (VAS) to determine the level of nipple pain and referred to the Traditional Chinese Medicine Standard for Diagnosis and Therapeutic Efficacy for Diseases and Syndromes to determine the healing time of their wounds. Results: The test group scored 3.70 ± 1.24 and 1.65 ± 0.74 points on the VAS on the first and third days following the intervention, whereas the control group scored 4.30 ± 0.94 and 2.23 ± 1.07 points, respectively. It took 3.75 ± 1.08 days and 4.45 ± 1.15 days for the nipple pain to completely disappear in the test group and the control group, respectively. The healing period for nipple trauma was 5.28 ± 1.26 days for the test group and 6.03 ± 1.61 days for the control group. All of the aforementioned distinctions were statistically significant (p < 0.05). Conclusions: Aloe gel can significantly alleviate the pain associated with nipple trauma in lactating women, accelerate wound healing, and reduce the duration of nipple trauma.

Factors affecting minimally invasive surgery utilization during elective colectomies for diverticular disease in the United States

BackgroundCompared with open surgery, minimally invasive surgery (MIS) has been shown to have improved outcomes when treating diverticular disease. This study aimed to analyze recent trends in MIS utilization for elective colectomy for diverticular disease and to identify individual variables and hospital characteristics associated with MIS utilization. MethodsThis population-based study examined individuals from the National Inpatient Sample who underwent elective colectomy for diverticular disease from 2016 to 2019. ResultsHospitals in the Midwest used MIS less than those in other geographic regions. Rural hospitals used MIS less than urban hospitals. Hospital bed size and teaching status were not associated with differences in MIS utilization. Patients with private insurance were more likely to have an MIS operation. There was also a racial disparity in MIS utilization, even after adjusting for insurance status. ConclusionsWhile there is no longer any variance in MIS utilization based on hospital bed size or teaching status, disparities concerning patient race remain, even after adjusting for insurance status. Further investigation is needed to determine the roots of these disparities.