VARIABLES INFLUENCING MEDICAL DECISIONS IN A CLINICAL REHABILITATION HOSPITAL

  • Carmen CUMPĂT “Alexandru Ioan Cuza” University, Department of Management, Iasi, Romania
  • Nicoleta ZOURI “Ryerson” University, Department of Computer Science, Toronto, Canada
  • Maria-Magdalena LEON-CONSTANTIN “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Alexandra MAȘTALERU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Eugenia MOROȘAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • F. MITU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Muthana ZOURI “Ryerson” University, Department of Computer Science, Toronto, Canada

Abstract

The discharge from the hospital represents a complex process that should assess the patient’s ability to adapt outside of the medical setting. Material and methods: This paper analyses the medical status of the patients admitted to a rehabilitation clinic, at the moment of discharge, considering a number of influencing factors, such as age, sex, place of origin, length of stay (LOS) in the hospital. In order to achieve this purpose, we conducted a study on 136 patients discharged from the Clinical Rehabilitation Hospital Iasi in 2016 using an econometric modelling. Results: Our findings reveal that the medical status of the patients at the time of discharge was not influenced by the sex or place of origin. Also, with an increase in patient’s age by one year, the estimated chances of a patient not to be cured at discharge decreases by 3.5%. In addition, with an increase in the patient’s length of stay in the hospital by one day, the estimated chances of a patient not being cured at discharge time increases by 8.1%. Conclusions: It was found that the age and the length of admission in the hospital has a significant influence on the disease stabilization, even if the patients are not fully cured at discharge time. Because the research only considered data from a single regional hospital, it limits the conclusions that can be drawn from the sample.

Author Biographies

Maria-Magdalena LEON-CONSTANTIN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)

Alexandra MAȘTALERU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)

Eugenia MOROȘAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Morpho-functional Sciences (I)

F. MITU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)

References

1. Millan J, Yunda L, Valencia A. Analysis of Economic and Business Factors Influencing Disruptive Innovation in Telehealth. Nova 2017; 15(28): 125-136.
2. Hendricks J, Cope V, Sundin D. Factors Influencing Medical Decision-Making For Seriously Ill Patients In The Acute Care Hospital. Annual Worldwide Nursing Conference (WNC 2017) 2017; 272-278 / doi: 10.5176/2315-4330_WNC17.130
3. Williams I, Brown H, Healy P. Contextual Factors Influencing Cost and Quality Decisions in Health and Care: A Structured Evidence Review and Narrative Synthesis. Int J Health Policy Manag 2018;7(8): 683-695.
4. Austin CA, Mohottige D, Sudore RL, Smith AK, Hanson LC. Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review. JAMA Intern Med 2015; 175(7): 1213-1221.
5. Bélanger E, Rodríguez C, Groleau D, Légaré F, Macdonald ME, Marchand R. Initiating decision-making conversations in palliative care: an ethnographic discourse analysis. BMC Palliat Care 2014; 13: 63 / doi: 10.1186/1472-684X-13-63.
6. Bae JM. Shared decision-making relevant concepts and facilitating strategies. Epidemiol Health 2017; 39: e2017048.
7. Hajjaj FM, Salek MS, Basra MK, Finlay AY. Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice. J R Soc Med 2010; 103(5): 178-187.
8. Matmari L, Uyeno J, Heck CS. Physiotherapists’ perceptions of and experiences with the discharge planning process in acute-care general internal medicine units in Ontario. Physiother Can 2014; 66(3): 254-263.
9. Pashley E, Powers A, McNamee N, Buivids R, Piccinin J, Gibson BE. Discharge from Outpatient Orthopaedic Physiotherapy: A Qualitative Descriptive Study of Physiotherapists’ Practices. Physiother Can 2010; 62(3): 224-234.
10. Kirk-Sanchez NJ, Roach KE. Relationship between duration of therapy services in a comprehensive rehabilitation program and mobility at discharge in patients with orthopedic problems. Phys Ther 2001; 81(3): 888-895.
11. Shahpar S, Wong AWK, Keeshin S, et al. Functional Outcomes of an Interdisciplinary Outpatient Rehabilitation Program for Patients with Malignant Brain Tumors. PM R 2018; 10(9): 926-933.
12. Morri M, Natali E, Tosarelli D. At discharge gait speed and independence of patients provides a challenge for rehabilitation after total joint arthroplasty: an observational study. Arch Physiother 2016; 6(1): 1-6 / doi: 10.1186/s40945-016-0020-6.
13. Bergés IM, Kuo YF, Ostir GV, Granger CV, Graham JE, Ottenbacher KJ. Gender and Ethnic Differ-ences in Rehabilitation Outcomes Following Hip Replacement Surgery. Am J Phys Med Rehabil 2008; 87(7): 567-572.
14. Mathijssen NM, Verburg H, van Leeuwen CC, Molenaar TL, Hannink G. Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting. Knee Surg Sports Traumatol Arthrosc 2016; 24(8): 2692-2696.
15. Henke RM, Karaca Z, Jackson P, Marder WD, Wong HS. Discharge Planning and Hospital Readmis-sions. Med Care Res Rev 2017; 74(3): 345-368.
16. Drugus D, Leasu F, Sechel G, Repanovici A, Azoicai D, Rogozea L. Assessment of personal qualities of healthcare professionals-determining factor for the improvement of healthcare services in the Ro-manian health system. Rev Med Chir Soc Med Nat Iasi 2015; 119(3): 843-848.
17. Rivera-Rodriguez AJ, Karsh BT. Interruptions and distractions in healthcare: review and reappraisal. Qual Saf Health Care 2010; 19: 304-312.
18. Chang HL, Li FS, Lin CF. Factors Influencing Implementation of Shared Medical Decision Making in Patients with Cancer. Patient Prefer Adherence 2019; 13: 1995-2005.
Published
2021-06-30
Section
PREVENTIVE MEDICINE - LABORATORY