Physical Restraint Usage in Hospitals Across the United States: 2011-2019
Objective: To determine the change in rates of physical restraint (PR) use and associated outcomes among hospitalized adults. Patients and Methods: Using national inpatient sample databases, we analyzed years 2011-2014 and 2016-2019 to determine trends of PR usage. We also compared the years 2011-20...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454823000784 |
| _version_ | 1827359077103042560 |
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| author | Ishaan Gupta, MBBS Ilana Nelson-Greenberg, MD Scott Mitchell Wright, MD Ché Matthew Harris, MD, MS |
| author_facet | Ishaan Gupta, MBBS Ilana Nelson-Greenberg, MD Scott Mitchell Wright, MD Ché Matthew Harris, MD, MS |
| author_sort | Ishaan Gupta, MBBS |
| collection | DOAJ |
| description | Objective: To determine the change in rates of physical restraint (PR) use and associated outcomes among hospitalized adults. Patients and Methods: Using national inpatient sample databases, we analyzed years 2011-2014 and 2016-2019 to determine trends of PR usage. We also compared the years 2011-2012 and 2018-2019 to investigate rates of PR use, in-hospital mortality, length of stay, and total hospital charges. Results: There were 242,994,110 hospitalizations during the study period. 1,538,791 (0.63%) had coding to signify PRs, compared with 241,455,319 (99.3%), which did not. From 2011 to 2014, there was a significant increase in PR use (p-trend<.01) and a nonsignificant increase in PR rates from 2016-2019 (p-trend=.07). Over time, PR use increased (2011-2012: 0.52% vs 2018-2019: 0.73%; p<.01). Patients with PRs reported a higher adjusted odds for in-hospital mortality in 2011-2012 (adjusted odds ratio [aOR], 3.9; 95% CI, 3.7-4.2; p<.01) and 2018-2019 (aOR, 3.5; 95% CI, 3.4-3.7; p<.01). Length of stay was prolonged for patients with PRs in 2011-2012 (adjusted mean difference [aMD], 4.3 days; 95% CI, 4.1-4.5; p<.01) and even longer in 2018-2019 (aMD, 5.8 days; 95% CI, 5.6-6.0; p<.01). Total hospital charges were higher for patients with PRs in 2011-2012 (aMD, +$55,003; 95% CI, $49,309-$60,679; p<.01). Following adjustment for inflation, total charges remained higher for patients with PRs compared with those without PRs in 2018-2019 (aMD, +$70,018; 95% CI, $65,355-$74,680; p<.01). Conclusion: Overall, PR rates did not decrease across the study period, suggesting that messaging and promulgating best practice guidelines have yet to translate into a substantive change in practice patterns. |
| first_indexed | 2024-03-08T06:21:26Z |
| format | Article |
| id | doaj.art-7cd49905e895445bb9511ab3097e5297 |
| institution | Directory Open Access Journal |
| issn | 2542-4548 |
| language | English |
| last_indexed | 2024-03-08T06:21:26Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj.art-7cd49905e895445bb9511ab3097e52972024-02-04T04:46:03ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482024-02-01813744Physical Restraint Usage in Hospitals Across the United States: 2011-2019Ishaan Gupta, MBBS0Ilana Nelson-Greenberg, MD1Scott Mitchell Wright, MD2Ché Matthew Harris, MD, MS3Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MDDepartment of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MDDepartment of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MDCorrespondence: Address to Ché Matthew Harris, MD, Johns Hopkins University, School of Medicine, Johns Hopkins Bayview Medical Center 5200 Eastern Avenue Baltimore, MD 21224.; Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MDObjective: To determine the change in rates of physical restraint (PR) use and associated outcomes among hospitalized adults. Patients and Methods: Using national inpatient sample databases, we analyzed years 2011-2014 and 2016-2019 to determine trends of PR usage. We also compared the years 2011-2012 and 2018-2019 to investigate rates of PR use, in-hospital mortality, length of stay, and total hospital charges. Results: There were 242,994,110 hospitalizations during the study period. 1,538,791 (0.63%) had coding to signify PRs, compared with 241,455,319 (99.3%), which did not. From 2011 to 2014, there was a significant increase in PR use (p-trend<.01) and a nonsignificant increase in PR rates from 2016-2019 (p-trend=.07). Over time, PR use increased (2011-2012: 0.52% vs 2018-2019: 0.73%; p<.01). Patients with PRs reported a higher adjusted odds for in-hospital mortality in 2011-2012 (adjusted odds ratio [aOR], 3.9; 95% CI, 3.7-4.2; p<.01) and 2018-2019 (aOR, 3.5; 95% CI, 3.4-3.7; p<.01). Length of stay was prolonged for patients with PRs in 2011-2012 (adjusted mean difference [aMD], 4.3 days; 95% CI, 4.1-4.5; p<.01) and even longer in 2018-2019 (aMD, 5.8 days; 95% CI, 5.6-6.0; p<.01). Total hospital charges were higher for patients with PRs in 2011-2012 (aMD, +$55,003; 95% CI, $49,309-$60,679; p<.01). Following adjustment for inflation, total charges remained higher for patients with PRs compared with those without PRs in 2018-2019 (aMD, +$70,018; 95% CI, $65,355-$74,680; p<.01). Conclusion: Overall, PR rates did not decrease across the study period, suggesting that messaging and promulgating best practice guidelines have yet to translate into a substantive change in practice patterns.http://www.sciencedirect.com/science/article/pii/S2542454823000784 |
| spellingShingle | Ishaan Gupta, MBBS Ilana Nelson-Greenberg, MD Scott Mitchell Wright, MD Ché Matthew Harris, MD, MS Physical Restraint Usage in Hospitals Across the United States: 2011-2019 Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | Physical Restraint Usage in Hospitals Across the United States: 2011-2019 |
| title_full | Physical Restraint Usage in Hospitals Across the United States: 2011-2019 |
| title_fullStr | Physical Restraint Usage in Hospitals Across the United States: 2011-2019 |
| title_full_unstemmed | Physical Restraint Usage in Hospitals Across the United States: 2011-2019 |
| title_short | Physical Restraint Usage in Hospitals Across the United States: 2011-2019 |
| title_sort | physical restraint usage in hospitals across the united states 2011 2019 |
| url | http://www.sciencedirect.com/science/article/pii/S2542454823000784 |
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