Relationship among diseases of the nervous- and circulatory systems, hospital length of stay and functional gain of patients in a private sub-acute hospital, Gauteng, South Africa

Abstract

Introduction: This study aimed to determine if a relationship between average length of stay of patients diagnosed with diseases of the nervous system (ICD-10 code G) and of the circulatory system (ICD-10 code I) and their functional gains private sub-acute hospital in Gauteng exists..

Method: A retrospective chart review study of patients with diseases of the nervous system (ICD-10 code G) and patients with diseases of the circulatory system (ICD-10 code I) admitted in Gauteng, South Africa, from 2017-2021. Descriptive statistics of percentages, median and range were used to summarise the data while inferential statistics of Mann-Whitney U, Kruskal-Wallis and Spearman rank correlation were used to determine median differences and relationship between the variables during data analysis.

Results: A total of 380 patient records were included in the study (n=380). The records with code “G” and “I” consisted of 24.7% and 75.3% respectively. The median length of stay (LOS) for code G and I were 29 (IQR 17-59.25) and 27 (IQR 14-42) days, respectively and the median differences were statistically significant (p=0.028). The median total functional outcomes achieved by patients with code G and I was 19 (IQR 3-30.25) and 22 (IQR of 9.75-35.25) respectively. The median differences were statistically significant (p=0.034).

Conclusion: Patients with diseases of the circulatory system (ICD 10 code I) have shorter length of stay and better functional outcomes in comparison to diseases of the nervous system (ICD 10 code G) patients. There is a direct relationship between LOS and functional outcomes of patients with diseases of the circulatory system (ICD-10 code I) but this was not seen with patients with diseases of the nervous system (ICD-10 code G).

Implications for practice

• Early identification of rehabilitation potential and referral to a sub-acute hospital is of utmost importance considering that patients with diseases of the nervous system (ICD 10 code G) require a longer length of stay and generally achieve less functional outcomes.
• Therapists and sub-acute hospitals should consider prioritising their resources with the aim of discharge preparation of patients with diseases of the nervous system (ICD 10 code G) earlier in the rehabilitation process.
• Sub-acute hospital case managers could potentially consider admission of patients with diseases of the circulatory system (ICD 10 code I) in a certain wing of the hospital considering that they displayed better functional outcomes with a shorter length of stay. Hence more patients with the same ICD-10 code could potentially be admitted more frequently to assist more patients in goal achievement.
• This does not imply that patients with diseases of the nervous system (ICD-10 code G) should receive less rehabilitation than patients with diseases of the circulatory system (ICD 10-code I), instead it is suggested that therapists and clinicians readjust their focus and plan their therapy programs to the expected functional outcomes.