Study cohort characteristics
| UAH (intervention site) | Edmonton teaching hospitals (intra-region controls) | Calgary teaching hospitals (extra-region controls) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| PRE (n=706) | POST (n=1190) | PRE vs POST (p value) | PRE (n=1960) | POST (n=2590) | PRE vs POST (p value) | PRE (n=1856) | POST (n=2239) | PRE vs POST (p value) | |
| Age, mean (SD) | 66.1 (20.4) | 65.3 (20.8) | 0.42 | 66.9 (18.1) | 67.0 (0.8) | 0.81 | 57.5 (19.7) | 58.5 (19.2) | 0.08 |
| Men | 343 (48.6) | 574 (48.2) | 0.88 | 976 (49.8) | 1304 (50.4) | 0.71 | 1025 (55.2) | 1176 (52.5) | 0.08 |
| Top five most responsible diagnoses (n, %) | |||||||||
| COPD | 64 (9.1) | 121 (10.2) | 194 (9.9) | 249 (9.6) | 87 (4.7) | 69 (3.1) | |||
| Pneumonia | 47 (6.7) | 67 (5.7) | 115 (5.9) | 124 (4.8) | 79 (4.3) | 99 (4.4) | |||
| Heart failure | 42 (6.0) | 71 (6.0) | 143 (7.3) | 136 (5.3) | 55 (3.0) | 82 (3.7) | |||
| Urinary tract infection | 51 (7.2) | 73 (6.1) | 65 (3.3) | 116 (4.5) | 36 (2.0) | 41 (1.8) | |||
| Venous thromboembolism | 20 (2.8) | 48 (4.0) | 54 (2.8) | 73 (2.8) | 80 (4.3) | 84 (3.8) | |||
| Charlson Score, mean (SD) | 2.84 (2.91) | 2.84 (2.74) | 0.99 | 3.18 (3.64) | 2.77 (2.68) | 0.0001 | 2.48 (4.3) | 1.97 (2.5) | 0.0001 |
| Comorbidities (based on index hospitalisation and prior 12 months) | |||||||||
| Hypertension | 401 (56.8%) | 694 (58.3%) | 0.52 | 1104 (56.3%) | 1460 (56.4%) | 0.98 | 616 (33.2%) | 754 (33.7%) | 0.74 |
| Diabetes mellitus | 205 (29%) | 358 (30.1%) | 0.63 | 617 (31.5%) | 793 (30.6%) | 0.53 | 539 (29%) | 670 (29.9%) | 0.54 |
| Fluid imbalance | 196 (27.8%) | 466 (39.2%) | 0.0001 | 586 (29.9%) | 788 (30.4%) | 0.7 | 499 (26.9%) | 574 (25.6%) | 0.37 |
| COPD | 222 (31.4%) | 378 (31.8%) | 0.88 | 708 (36.1%) | 836 (32.3%) | 0.01 | 297 (16%) | 289 (12.9%) | 0.005 |
| Psychiatric disorder | 236 (33.4%) | 411 (34.5%) | 0.62 | 503 (25.7%) | 692 (26.7%) | 0.42 | 238 (12.8%) | 260 (11.6%) | 0.24 |
| Pneumonia | 176 (24.9%) | 302 (25.4%) | 0.83 | 514 (26.2%) | 572 (22.1%) | 0.001 | 376 (20.3%) | 386 (17.2%) | 0.01 |
| Anemia | 122 (17.3%) | 222 (18.7%) | 0.45 | 431 (22%) | 545 (21%) | 0.44 | 251 (13.5%) | 280 (12.5%) | 0.33 |
| Trauma | 153 (21.7%) | 259 (21.8%) | 0.96 | 418 (21.3%) | 487 (18.8%) | 0.03 | 245 (13.2%) | 273 (12.2%) | 0.33 |
| Atrial fibrillation | 136 (19.3%) | 236 (19.8%) | 0.76 | 368 (18.8%) | 444 (17.1%) | 0.15 | 216 (11.6%) | 253 (11.3%) | 0.74 |
| Heart failure | 109 (15.4%) | 212 (17.8%) | 0.18 | 340 (17.3%) | 400 (15.4%) | 0.09 | 166 (8.9%) | 229 (10.2%) | 0.17 |
| Drug abuse | 111 (15.7%) | 185 (15.5%) | 0.92 | 300 (15.3%) | 375 (14.5%) | 0.44 | 232 (12.5%) | 230 (10.3%) | 0.02 |
| Cancer | 76 (10.8%) | 155 (13%) | 0.15 | 287 (14.6%) | 356 (13.7%) | 0.39 | 261 (14.1%) | 256 (11.4%) | 0.01 |
| Renal disease | 63 (8.9%) | 142 (11.9%) | 0.04 | 248 (12.7%) | 269 (10.4%) | 0.02 | 194 (10.5%) | 146 (6.5%) | 0.0001 |
| Dementia | 112 (15.9%) | 161 (13.5%) | 0.16 | 226 (11.5%) | 290 (11.2%) | 0.73 | 94 (5.1%) | 73 (3.3%) | 0.004 |
| Mild liver disease | 44 (6.2%) | 78 (6.6%) | 0.78 | 180 (9.2%) | 170 (6.6%) | 0.001 | 186 (10%) | 184 (8.2%) | 0.05 |
| Cerebrovascular disease | 53 (7.5%) | 91 (7.6%) | 0.91 | 207 (10.6%) | 227 (8.8%) | 0.04 | 96 (5.2%) | 82 (3.7%) | 0.02 |
| Gastrointestinal bleed | 22 (3.1%) | 40 (3.4%) | 0.77 | 124 (6.3%) | 131 (5.1%) | 0.07 | 193 (10.4%) | 219 (9.8%) | 0.51 |
| Asthma | 46 (6.5%) | 72 (6.1%) | 0.69 | 154 (7.9%) | 154 (5.9%) | 0.01 | 109 (5.9%) | 78 (3.5%) | 0.0003 |
| Stroke | 29 (4.1%) | 62 (5.2%) | 0.28 | 143 (7.3%) | 137 (5.3%) | 0.001 | 72 (3.9%) | 62 (2.8%) | 0.05 |
| Prior myocardial infarction | 48 (6.8%) | 99 (8.3%) | 0.23 | 127 (6.5%) | 119 (4.6%) | 0.001 | 58 (3.1%) | 16 (0.7%) | 0.0001 |
| Arthritis | 29 (4.1%) | 51 (4.3%) | 0.85 | 77 (3.9%) | 96 (3.7%) | 0.7 | 114 (6.1%) | 81 (3.6%) | 0.0002 |
| Peripheral vascular disease | 18 (2.5%) | 61 (5.1%) | 0.01 | 82 (4.2%) | 80 (3.1%) | 0.05 | 87 (4.7%) | 71 (3.2%) | 0.01 |
| Severe liver disease | 9 (1.3%) | 17 (1.4%) | 0.82 | 77 (3.9%) | 61 (2.4%) | 0.002 | 111 (6%) | 107 (4.8%) | 0.09 |
| Valve disease | 23 (3.3%) | 44 (3.7%) | 0.56 | 84 (4.3%) | 65 (2.5%) | 0.97 | 57 (3.1%) | 25 (1.1%) | 0.05 |
| Paralysis | 17 (2.4%) | 34 (2.9%) | 0.62 | 64 (3.3%) | 84 (3.2%) | 0.009 | 50 (2.7%) | 40 (1.8%) | 0.0001 |
| Skin ulcer | 19 (2.7%) | 31 (2.6%) | 0.78 | 55 (2.8%) | 60 (2.3%) | 0.3 | 42 (2.3%) | 9 (0.4%) | 0.0001 |
| Shock | 11 (1.6%) | 17 (1.4%) | 0.91 | 31 (1.6%) | 30 (1.2%) | 0.22 | 53 (2.9%) | 46 (2.1%) | 0.1 |
| HIV | 13 (1.8%) | 17 (1.4%) | 0.49 | 37 (1.9%) | 20 (0.8%) | 0.001 | 41 (2.2%) | 17 (0.8%) | 0.0001 |
| Protein calorie malnutrition | 2 (0.3%) | 5 (0.4%) | 0.63 | 1 (0.1%) | 4 (0.2%) | 0.4 | 0 (0%) | 1 (0%) | 0.9 |
| Features of index hospitalisation | |||||||||
| Resource intensity weight* | 1.38 (1.13) | 1.42 (1.25) | 0.52 | 1.55 (1.59) | 1.49 (1.31) | 0.18 | 1.21 (0.95) | 1.21 (1.0) | 0.92 |
| LACE score, mean (SD) | 10.53 (3.1) | 10.23 (3.1) | 0.04 | 11.49 (2.9) | 11.00 (3.0) | 0.0001 | 9.78 (3.0) | 9.4 (2.9) | 0.0001 |
| Expected LOS, mean (SD) | 7.2 (4.4) | 8.0 (6.1) | 0.001 | 7.60 (4.8) | 7.78 (0.5.9) | 0.28 | 6.71 (4.8) | 6.67 (4.8) | 0.8 |
*Resource intensity weight values provide a measure of a patient's relative resource consumption compared with an average typical inpatient cost and are generated by the Canadian Institute of Health Information.
LACE is based on LOS for the index hospitalisation (L), acuity of admission (A), Charlson comorbidity score (C) and emergency room utilisation in the prior 6 months (E).
LOS, length of stay; UAH, University of Alberta Hospital.