Few studies examining the relationship between implementation of RRTs and health outcomes have been performed in the United States, and no studies have explored the relationships between RRT interventions and patient health outcomes among multiple, geographically contiguous hospitals. The aim of the study was to describe the differences in patient health outcomes before and after the implementation of RRTs within Washington State tertiary hospitals.
Patients hospitalized at 12 tertiary hospitals were assigned to either a pre-RRT (n=258,843) or post-RRT (n=269,015) cohort based on the RRT implementation timeframe of the individual institutions. Study outcomes included cardiac arrests, cardiac arrest deaths, and in-hospital mortality, prolonged length of stay and 30-day hospital readmission. Binary logistic regression controlling for age, sex, payer, comorbidity, previous hospitalization, primary diagnosis category, and length of stay were completed.
A statistically significant improvement was observed in patient health outcomes in the post-RRT cohort when compared to the pre-RRT cohort; in-hospital mortality (OR=0.89; 95%CI=0.86-0.92; p<0.001), cardiac arrest rates (OR=0.88; 95%CI=0.83-0.93; p<0.001), cardiac arrest deaths (OR=0.75; 95%CI=0.64-0.88; p<0.001), prolonged length of stay (OR=0.89; 95%CI=0.88-0.91; p<0.001), 30-day re-hospitalization (OR=0.97; 95%CI=0.95-0.98; p<0.001).
This is the first study to demonstrate the relationship between implementation of an RRT and improvement in patient health outcomes within multiple, geographically contiguous hospitals.
|Advisor:||Daratha, Kenneth B.|
|Commitee:||Bindler, Ruth, Corbett, Cindy, Roll, John|
|School:||Washington State University|
|School Location:||United States -- Washington|
|Source:||DAI-B 74/07(E), Dissertation Abstracts International|
|Keywords:||Binary logistic regression, Hospital readmission, Patient health outcomes, Rapid response teams|
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