Hospital Medical Observation at the Community Level

Abstract

Background

Medical Observation programs have been implemented by Medicare and other payors during the past several years. These programs have focused on the movement of internal medicine patients with short lengths of stay to outpatient care.

Method

This study described the utilization of Medical Observation patients in the hospitals of Syracuse, New York during a twelve month period between 2016 and 2017.  The objective of the study was to characterize the use of Medical Observation as a separate service within the hospitals.

Results

The data demonstrated that, during the twelve month period, there were 16,190 patients identified for Medical Observation in the Syracuse hospitals. They comprised 32.8 percent of the combined observation and inpatient adult medicine population.  Individual hospital proportions were consistent within each of the hospitals but varied from 25 to 41 percent among them.  

In the hospitals, 60 percent of the Medical Observation patients in the hospitals were associated with circulatory, digestive, nervous system, and respiratory Major Diagnostic Categories.  More than 90 percent of the total were at Minor and Moderate severity of illness.

Conclusions

The study suggested that Medical Observation has focused attention on the needs of short stay internal medicine patients in hospitals.  It identified volumes and clinical characteristics of this population.  Additional studies of the utilization and impact of this service would be useful.