Outcomes in General Internal Medicine Inpatients

Abstract

This thesis describes 3 thematically linked projects exploring outcomes for hospitalized medical patients. Project 1 examines the accuracy of various models in predicting post-discharge outcomes in patients with heart failure (HF). Project 2 explores the relationship between teaching and non-teaching services on clinical outcomes for patients admitted to general internal medicine (GIM) services. Using the risk adjustment model developed in project 1 and the covariates identified in project 2, project 3 explores whether post-discharge outcomes differed for weekend vs. weekday discharges for HF patients in teaching vs. non-teaching hospitals. The work from this thesis confirms that post-discharge adverse outcomes such as readmission or death are common in Alberta, are affected by multiple factors, and are not easily predicted using currently available models. Future efforts to identify and intervene in patients at high risk of readmissions will need to consider factors beyond those we studied if they are to be successful.