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Activity Number:
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427
- Contributed Poster Presentations:Government Statistics Section
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Type:
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Contributed
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Date/Time:
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Tuesday, July 31, 2018 : 2:00 PM to 3:50 PM
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Sponsor:
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Government Statistics Section
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Abstract #328476
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Title:
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The Effect of Facility Characteristics on VA ICU Patient Outcomes
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Author(s):
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Amy May Johnson O'Shea* and Spyridon Fortis and Mary Vaughan Sarrazin and Jane Moeckli and Heather Schacht Reisinger
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Companies:
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Iowa City VA Health Care System & University of Iowa College of Medicine, Iowa City IA and Iowa City VA Health Care System & University of Iowa College of Medicine, Iowa City IA and Iowa City VA Health Care System & University of Iowa College of Medicine, Iowa City IA and Iowa City VA Health Care System, Iowa City IA and Iowa City VA Health Care System & University of Iowa College of Medicine, Iowa City IA
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Keywords:
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United States Department of Veteran Affairs;
Intensive Care Unit;
Critical Care;
Rurality;
Outcomes;
Veterans
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Abstract:
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Among Veterans, research shows rural residents are often hospitalized in rural intensive care units (ICUs) with low case-volume, which often leads to unfavorable outcomes compared to urban settings. This study evaluated facility factors on mortality, length of stay, and acute inter-hospital transfers in Veterans Affairs (VA) ICUs and included 73,110 admissions; 2010-2015. Facilities were classified by the Rural Urban Commuting Area code algorithm as large rural (N=6) or urban (N=32), overall ICU volume into low, medium, or high tertiles, and teleintensivist program access. Unadjusted analyses and multivariate hierarchical models were used. Facility rurality and ICU volume were not associated with patient outcomes. Teleintensivist access saw a decline in ICU mortality (OR=0.31; 95% CI=0.21-0.45). Acute inter-hospital transfers decreased (OR=0.66; 95% CI=0.52-0.82) but were more likely among tele-ICU hospitals at study end. Resource access and HOW care is provided may be more influential than facility characteristics on patient outcomes. Future work could further elucidate what hospital level practices drive patient outcomes and allow targeted opportunity for meaningful change.
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Authors who are presenting talks have a * after their name.
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