Outpatient management of hyperemesis gravidarum and the imact on inpatient admissions: a retrospective observational study
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Ucyigit, Miss Asli
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Issue Date
2020
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Article
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OBJECTIVES: The objectives of this study were to investigate the impact of the Ambulatory Hyperemesis Unit at an inner-city teaching hospital since its establishment in 2012, on both the inpatient admission rate and length of stay for hyperemesis gravidarum, and to provide an estimate of the financial impact this service has on the hospital trust. STUDY DESIGN: A retrospective observational analysis was undertaken at King's College Hospital, London, spanning a 12 year period. Data were collected from the admissions database, both before and after the unit opened. The number of inpatient spells per year, inpatient nights per year and length of stay were analysed (unpaired t-test). The estimated cost of inpatient care for hyperemesis gravidarum prior and subsequent to the unit opening was also compared. RESULTS: The average number of inpatient spells per year before and after the unit opened was 243.25 and 254.13 spells respectively (p = 0.6128). The average number of inpatient nights per year was 424.5 vs. 227.38 nights respectively (p < 0.0001). The average length of inpatient stay per spell was 1.74 vs. 0.89 nights respectively (p < 0.0001). The estimated average cost of inpatient stays per year was £199,535 versus £106,866 respectively (p < 0.0001). CONCLUSIONS: Although the total number of inpatient admissions did not appear to alter after outpatient services were established, the length of stay per patient admission and total number of inpatient nights per year were significantly reduced. This benefit is sustained over many years, and is likely due to the focused and accessible aftercare the ambulatory hyperemesis unit provides. As a consequence, there was a substantial estimated cost-saving to the hospital trust, of almost £100,000 per year.
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European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume
254