ABSTRACT
Objectives: Strategies to maintain hospital capacity during the COVID-19 pandemic included reducing hospital length of stay (LOS) for infected patients. We sought to evaluate the association between LOS and enrollment in the COVID Accelerated Care Pathway, which consisted of a hospital observation protocol and postdischarge automated text message–based monitoring. Study Design: Retrospective matched cohort study of patients hospitalized from December 14, 2020, to January 31, 2021. Methods: Participants were patients who presented to the emergency department with acute infection due to COVID-19, required hospitalization, and met pathway inclusion criteria. Participants were compared with a propensity score–matched cohort of patients with COVID-19 admitted to the same hospital during the 7 weeks preceding and following pathway implementation. Results: There were 44 patients in the intervention group and 83 patients in the propensity score–matched cohort. The mean (SD) hospital LOS for patients in the intervention group was 1.7 (2.6) days compared with 3.9 (2.3) days for patients in the matched cohort (difference, –2.2 days;95% CI, –3.3 to –1.1). In the intervention group, 2 patients (5%;95% CI, 0%-15%) were rehospitalized within 14 days compared with 8 (10%;95% CI, 4%-17%) in the matched cohort. Conclusions: Patients with COVID-19 who were managed through an accelerated hospital observation protocol and postdischarge monitoring service had reduced hospital LOS compared with patients receiving standard care. Hospital preparedness for future public health emergencies may involve the design of pathways that reduce the time that patients spend in the hospital, lower cost, and ensure continued recovery upon discharge.
ABSTRACT
Several facts about antithrombotic agents in patients with COVID-19 are presented. Among other things, coagulopathy and thrombosis are associated with poor outcomes in patients hospitalized with COVID-19. COVID-19 is associated with hypercoagulability and endothelial injury, which contribute to an increased risk of macro- and microvessel thrombosis, disease progression and death.
ABSTRACT
This paper draws policy insights from the first comparative analysis of multiple hotspots of regional cultural and creative activity across Australia. Focussing on the state of Queensland, it provides three interlinked findings relevant to international cultural policy debates. The first–municipal agency–goes to the crux of the value of studying small regions. We examine the degree to which Cairns, an isolated, small regional city, can exercise effective cultural agency in a tripartite system of government, demonstrating that policy ambition and asset management at the local level can deliver outsized cultural infrastructure benefits through a focus on demand from the local community. The second further illuminates the question of demand for cultural infrastructure as a critical enabler, in conjunction with allied infrastructure, in a very remote, distressed community–the Central West region. Cultural tourism’s surprising prominence as support for mainstream tourism on the Gold Coast, an international mecca for surf, sand and sun, is the third example, deepening the significance of allied industry connectivity. Drawing on fieldwork conducted in 2019, the trend data and analysis offered here will be significantly impacted by the global COVID-19 pandemic of 2020. © 2020 Informa UK Limited, trading as Taylor & Francis Group.