Changes in admissions, lengths of stay, and discharge diagnoses at a major university-affiliated teaching hospital: implications for medical education.
Acad Med
; 64(5): 253-8, 1989 May.
Article
en En
| MEDLINE
| ID: mdl-2496698
The implications for medical education of a declining average length of stay (ALOS) and changes in numbers of hospital admissions have been the subject of considerable discussion. The changing hospital reimbursement schedules and the rise of managed-care systems have altered patterns of hospital use and consequently posed new problems for the education of medical students and residents. Between 1980 and 1986 in one university-affiliated hospital, the ALOS for patients with any of the most frequent discharge diagnoses for either of those years had declined 34% since 1980, despite a 59% increase in the number of patients with those diagnoses. Patients with any one of 21 of the 88 most frequent discharge diagnoses for 1986 were hospitalized for less than one day. Those patients with another eight of the disorders had an ALOSs of between one and two days; some of these patients had serious and common gastrointestinal disorders. Discharge diagnoses were categorized by the hospital service in which students and residents would have rotations and were analyzed for changes in case mix. This study showed that for the hospital's medical students and residents to be exposed to the same case mix of clinical disorders that were seen in-hospital in 1980, it is now necessary for them to have experience in the ambulatory setting.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Admisión del Paciente
/
Grupos Diagnósticos Relacionados
/
Hospitales de Enseñanza
/
Tiempo de Internación
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Acad Med
Asunto de la revista:
EDUCACAO
Año:
1989
Tipo del documento:
Article
Pais de publicación:
Estados Unidos