Hospitalized but Not Admitted Characteristics of Patients With “Observation Status” at an Academic Medical Center

JAMA: November 25, 2013

Importance  The Centers for Medicare & Medicaid Services (CMS) defines observation status for hospitalized patients as a “well-defined set of specific, clinically appropriate services,” usually lasting less than 24 hours, and that in “only rare and exceptional cases” should last more than 48 hours. Although an increasing proportion of observation care occurs on hospital wards, studies of patients with observation status have focused on the efficiency of dedicated units.

Objective  To describe inpatient and observation care.

Design and Setting  Descriptive study of all inpatient and observation stays between July 1, 2010, and December 31, 2011, at the University of Wisconsin Hospital and Clinics, a 566-bed tertiary academic medical center.

Participants  All patients with observation or inpatient stays during the study period.

Main Outcomes and Measures  Patient demographics, length of stay, difference between cost and reimbursement per stay, and percentage of patients discharged to skilled nursing facilities. Read More