'Off-service' patient placements linked to worse outcomes, study finds

Patients placed "off-service" in wards specializing in areas of care they do not require have longer hospital stays and a higher chance of being readmitted within 30 days of discharge, according to a study published in the upcoming Informs journal Management Science.

Many hospitals place patients "off-service" to provide them with a bed when the ward to which they belong is full. The study's researchers examined 2016-19 data from a large academic medical center in the northeastern U.S. They found "off-service" placements added 3,995 patient-days per year in the hospital, equivalent to 11 additional occupied beds per day.

Patients placed "off-service" also had lengths of stay that were 22.8 percent longer than those placed in the correct wards. They were 13.1 percent more likely to be readmitted to the hospital within 30 days of initial discharge.

The study also found patients placed "off-service" had better outcomes when they were placed in closer physical proximity to their appropriate wards. Surprisingly, placements in wards with patients who have clinically similar conditions did not make as much of a difference.

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