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Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

This study aims to analyze how different room-committing practices affect the occupancy and profitability of hotels and it critically reviews the role of minimum-length-of-stay (MLOS) requirements given these findings.

The approach uses statistical analysis of simplified contexts to develop understanding, and simulations of more complex situations to confirm the relevance in realistic contexts.

The study demonstrates that proper solutions of the room-committing problem improve occupancy and profitability, in particular, for hotels working in high-season and high-occupancy situations. Smart committing algorithms diminish the role of MLOS requirements. More demand can be accepted without sacrificing late-arriving long reservations.

To the best of the authors’ knowledge, this work, building upon a previous one cited in this paper, is the first to rigorously study the room-committing problem and to demonstrate its relevance in practical situations and its implications on MLOS rules.

Patient length of stay (LOS) is an important indicator of emergency department (ED) performance. Investigating factors that influence LOS could thus improve healthcare delivery and patient safety. Previous studies have focused on patient-level factors to explain LOS variation, with little research into service-related factors. This study examined the association between LOS and multi-level factors including patient-, service- and organization-level factors.

This study uses a retrospective observational design to identify a cohort of patients from arrival to discharge from ED. A year-long data regarding patients flow trhoguh ED were analyzed using analytics techniques and multi-regression models. The response variable was patient LOS, and the independent variables were patient characteristics, service-related factors and organizational variables.

The findings of this study showed that older patients, middle triage and hospitalization were all associated with longer LOS. Service-related factors such as complexity of care provided, initial ward designation and ward transfer had a significant impact as well. Finally, prolonged LOS was associated with a higher ratio of patients per medical doctor and per nurse. In contrast, a higher number of residents in the ED were associated with longer patient LOS.

Previous studies on patient LOS have focused on patient-level factors, with little research on service-related factors. This study has addressed that gap by examining the association between LOS and multi-level factors including patient-, service- and organization-level factors. Patient-level factors included demographics, acuity, arrival shift, arrival mode and discharge type. Service-level factors consisted of first ward, ward transfer and complexity of care provided. Organizational factors consisted of three ratios: patients per MD, patients per nurse and patients per resident. The results add to the current understanding of factors that increase patient LOS in EDs and contribute to the body of knowledge on ED performance, operation management and quality of care. The study also provides practical and managerial insights that could be used to improve patient flow in EDs and reduce LOS.

The purpose of this paper is to explore the link between one aspect of primary care in England – the annual review by general practitioners for dementia patients – and length of hospital stay (LoS). The annual review should identify the needs of both patients and carers and co-ordinate services across health and social care to address those needs. If this is done well, timely discharge from hospital may be facilitated.

The study uses linked national data from 2006/2007 to 2010/2011 on over 36,000 patients, employing sophisticated statistical techniques to isolate the effect of the annual dementia review on LoS.

Hospital patients discharged to the community have significantly shorter stays if they are cared for by practices that reviewed a higher percentage of their patients with dementia. However, this effect is small and is not evident for patients discharged to care homes or who died in hospital. Longer LoS is associated with a range of co-morbidities, markers of low availability of social care and with intensive provision of informal care.

Although the dementia review has only a modest effect on LoS, the components of the review could improve the health and well-being of those with dementia and their carers.

The study is the first to employ a robust methodology to investigate the impact of the annual dementia review on hospital LoS, an important aspect of the interface between primary and secondary care. There are implications for clinical and financial aspects of health and social care policy.

This research proposes to organise and distil this massive amount of data, making it easier to understand. Using data mining, machine learning techniques and visual approaches, researchers and managers can extract valuable insights (on guests' preferences) and convert them into strategic thinking based on exploration and predictive analysis. Consequently, this research aims to assist hotel managers in making informed decisions, thus improving the overall guest experience and increasing competitiveness.

This research employs natural language processing techniques, data visualisation proposals and machine learning methodologies to analyse unstructured guest service experience content. In particular, this research (1) applies data mining to evaluate the role and significance of critical terms and semantic structures in hotel assessments; (2) identifies salient tokens to depict guests' narratives based on term frequency and the information quantity they convey; and (3) tackles the challenge of managing extensive document repositories through automated identification of latent topics in reviews by using machine learning methods for semantic grouping and pattern visualisation.

This study’s findings (1) aim to identify critical features and topics that guests highlight during their hotel stays, (2) visually explore the relationships between these features and differences among diverse types of travellers through online hotel reviews and (3) determine predictive power. Their implications are crucial for the hospitality domain, as they provide real-time insights into guests' perceptions and business performance and are essential for making informed decisions and staying competitive.

This research seeks to minimise the cognitive processing costs of the enormous amount of content published by the user through a better organisation of hotel service reviews and their visualisation. Likewise, this research aims to propose a methodology and method available to tourism organisations to obtain truly useable knowledge in the design of the hotel offer and its value propositions.

Introduction: The birth of a preterm child requires hospitalization in a neonatal intensive care unit (NICU), which is a very stressful experience for parents. Aim: To determine the stress level of parents of preterm babies admitted to intensive and sub-intensive units in two hospitals in Northern Italy and its association with their sociodemographic variables and the clinical conditions of their newborns.

The sampling was non-probabilistic and included parents of preterm babies admitted to intensive and/or sub-intensive care for at least 10 days. Instruments: (1) information deduced from the clinical record of preterm newborns; (2) sociodemographic determinants of parents' well-being deduced from a questionnaire; (3) parental stress scale: neonatal intensive care unit (PSS:NICU), which measures the perception of parents about stressors from the physical and psychological environment of the NICU.

Results: A total of 104 parents of 59 hospitalized preterm babies participated in the study. The average parental stress level was 1.87 ± 0.837. The subscale score that got higher was parent-infant relationship subscale. Concerning the infant characteristics, the birth weight of the babies and the length of their hospitalization affected the parents' stress level. Looking at parents' sociodemographic characteristics instead, the greater predictors were gender, age and occupational social class.

The parental role alteration caused by infant premature birth and consequent hospitalization is a major stressor for parents and in particular for mothers. The variables that resulted positively associated with higher stress in parents of preterm infants hospitalized are specific parental characteristics, including not adequately or previously studied ones, and infant characteristics.

The diagnostic process after referral to an acute psychiatric treatment facility consists of more than the clinical investigation and laboratory tests. Psychometric tests in a broad range of languages may be such an augmentation of our diagnostic armamentarium. Whether such tests are in use, and how they are distributed among different patient categories was the aim of the study. All referrals in one calendar year (N=1168), as they are depicted in the hospital computerized medical records, were investigated. Fifty-six (6.1%) out of 926 ethnic Norwegians and six (3.0%) out of 198 non-Western immigrants were tested, whereas none of the 44 Western immigrants. The difference between ethnic Norwegians and the immigrants was significant (Z=-3.05 and P=0.002). Psychometric tests were thus almost not in use, and even lesser so in immigrants. Mean number of resident days was higher among those tested, 11.7 (SD=11.2) versus those not tested, 7.4 (SD=10.4) days, t=2.97 and P=0.004. Length of stay for ethnic Norwegians did not differ from that for non-Western immigrants 11.4 versus 11.7, respectively. The patients tested were older than those not tested. Mean age was 43.0 (SD=14.4) versus 38.8 (SD=12.1), with a t=2.65 and P=0.03. The difference in resident days between all immigrants and ethnic Norwegians was significant with a Z=−2.232 and P=0.026. Level of testing was higher in ethnic Norwegians, and the tested patients stayed longer, maybe indicating more room for testing. Whether this low test-activity influences treatment quality is an unsettled question.

The reduction of costs has a more and more relevant role in the healthcare context, therefore, a large effort is done by health providers to this aim, for example, by reducing the length of hospital stay (LOS) of patients undergoing surgery. Fast track surgery fits perfectly this issue and was applied to patients undergoing knee replacement surgery due to Osteoarthritis, one of the most common diseases of aged population. The paper aims to discuss these issues.

Lean six sigma was applied to analyze the implementation of fast track surgery through the define, measure, analyze, improve, control roadmap, used as a typical problem-solving approach. It is characterized by five operational phases, which make possible the achievement of fixed goals through a rigorous process of defining, measuring, analyzing, improving and controlling business problems.

The corrective action, consisting in the application of fast track surgery, improved both effectiveness and efficiency of the process of care. The average length of hospital stay (LOS) was reduced from 8.34 to 6.68 days (–19.9 percent) and its standard deviation from 2.41 to 1.99 days (–17.1 percent). The statistical significance of this decrease was verified by means of proper tests. Moreover, some variables influencing the LOS were identified.

The follow up and the satisfaction of patients were not analyzed and could be a future development of this study.

Patients will experience a faster recovery while the hospital will benefit from a rise of available beds. The effect is a general improvement of hospital management.

The introduction of fast track surgery for patients undergoing knee replacement surgery made significantly reduce LOS and, consequently, costs’ with a money saving of more than 50,000 euro per year.

Health services continue to face economic and capacity challenges. Quality improvement (QI) methods that can improve clinical care processes are therefore needed. However, the successful use of current QI methods within hospital settings remains a challenge. There is considerable scope for improvement of elective clinical pathways, such as hip and knee replacement, and so the use and study of QI methods in such settings is warranted.

A model to manage variability was adapted for use as a QI method and deployed to improve a hip and knee replacement surgical pathway. A prospective observational study, with a mixed-methods sequential explanatory design (quantitative emphasised) that consisted of two distinct phases, was used to assess its effectiveness.

Following the use of the novel QI method and the subsequent changes to care processes, the length of hospital stay was reduced by 18%. However, the interventions to improve care process highlighted by the QI method were not fully implemented. The qualitative data revealed that staff thought the new QI method (the model to manage variability) was simple, effective, offered advantages over other QI methods and had highlighted the correct changes to make. However, they felt that contextual factors around leadership, staffing and organisational issues had prevented changes being implemented and a greater improvement being made.

The quality of QI reporting in surgery has previously been highlighted as poor and lacking in prospective and comprehensively reported mixed-methods evaluations. This study therefore not only describes and presents the results of using a novel QI method but also provides new insights in regard to important contextual factors that may influence the success of QI methods and efforts.