Faculty Collaboration Database

Leveraging Social Determinants of Health to Reduce Hospital Length of Stay: A Pilot QI Project for Solid Tumor Oncology Patients During the COVID-19 Pandemic. WMJ 2022 Oct;121(3):205-211

Date

10/28/2022

Pubmed ID

36301647

Scopus ID

2-s2.0-85140859344 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

PURPOSE: The impact of the social determinants of health (SDOH) on hospitalized cancer patients and hospital length of stay is unknown. At our institution, a hospital-wide SDOH survey that examined patient-specific barriers to various domains of SDOH and facilitated hospital discharge was integrated into the electronic medical record. This study reports the effect of the SDOH survey on length of stay for oncology patients and the outpatient referrals generated to facilitate the discharge.

METHODS: We examined length of stay index data on inpatient oncology patients and 2 comparator services (bone marrow transplant, internal medicine). We evaluated the length of stay using a 2-sample t test, and the rate of referrals per discharge using a 2-sample Poisson test.

RESULTS: Compared to the baseline length of stay, after the launch of the SDOH survey, there was a significant (8.9%) decrease in the average length of stay for oncology patients (8.14 to 7.41 days, P = 0.004), the LOS decrease for the bone marrow transplant and subset was a nonsignificant trend only (P > 0.1). Average referrals per discharge increased from baseline 1.063 per discharge to 1.159 after implementation (P = 0.004), and the mean values increased by 9%.

CONCLUSIONS: The SDOH survey tool assisted in a timely examination of patient-specific barriers to discharge, leveraged care coordination, and facilitated a safe hospital discharge. Such efforts increase the efficiency of health care service delivery in response to public health threats, such as the COVID-19 pandemic.

Author List

Kamaraju T, Atkinson D, Wright T, Charlosn J, Wetzel T, Campbell G, Cadman J, Williams J, Egede L, Retseck J, Banerjee A, Ehrlich V, Stolley M, Power S

Authors

Anjishnu Banerjee PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin
John A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Sailaja Kamaraju MBBS, MS Professor in the Medicine department at Medical College of Wisconsin
Janet Retseck PhD, MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Melinda Stolley PhD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Joni Williams MPH, MD Center Director, Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Hospitals
Humans
Length of Stay
Neoplasms
Pandemics
Social Determinants of Health