Dr. Sweeney Co-PI on NIH Grant to Study Hospital Discharge Decision-Making

December 2010

A research team co-directed by Dr. John Sweeney, chief of the Division of General and Gastrointestinal Surgery of the Department of Surgery at Emory and director of the department's Clinical Quality and Patient Safety program, and James C. Cox, director of the Experimental Economics Center of the Andrew Young School of Policy Studies at Georgia State University, received a three year collaborative award from the NIH's National Institute on Aging to fund "Uptake of Comparative Effectiveness Research: Implications for Discharge Decision."

The project will focus on hospital length of stay as a central factor in the increasingly important and complex interplay between quality of health care delivery and medical costs and will experiment with alternative choices and new applications of information technology designed to increase physicians' effectiveness in identifying the optimal time to discharge a patient.

"The inpatient environment bolsters the intensity of care, and indeed longer hospital stays have been associated with a lower incidence of adverse outcomes leading to readmissions," says Dr. Sweeney. "However, the hospital is also an exceptionally expensive care delivery environment, both financially and in terms of nosocomial illness and iatrogenic risk, and unnecessarily prolonged stays can precipitate higher costs and lower quality of care."

The team will examine the uptake of comparative effectiveness research (CER) for the discharge decision in patients who have undergone complex surgical resections for GI malignancy, focusing on how well hospital discharge decisions in recent practice conform to the CER while also observing the results of an alternative choice architecture designed to promote better CER uptake for the discharge.