The Influence of Teaching vs. Non-teaching Hospitals on Length of Stay and Discharge Status for Adult CVT Patients
Shreya Chalapalli1, Madeleine Brownfield1, Kate Burnes1, Qasim Chohdry1, Milo Coffee1, David Walsh1, Parashar Koirala2
1University of Missouri-Kansas City School of Medicine, 2University Health Truman Medical Center
Objective:

This study aims to evaluate the influence of hospital teaching status on length of stay (LOS) and discharge disposition among adult patients with cerebral venous thrombosis (CVT).

Background:

CVT is a rare but potentially fatal neurological condition that disproportionately affects younger adults and women of reproductive age. Teaching hospitals often serve as referral centers for complex cases, yet it is unclear how teaching status affects patient outcomes, such as LOS and discharge plans.

Design/Methods:
A retrospective cohort study was conducted using 487 adult CVT patients (ages 18–89) identified in the Cerner HealthFacts database (2010–2016). Patients admitted through the emergency department were included. Pediatric cases and those leaving against medical advice were excluded. Outcomes of interest were LOS (<4, 4–9, 10–13, ≥14 days) and discharge disposition (home vs. follow-up care). Ordinal logistic regression was used to analyze associations between hospital teaching status and outcomes, adjusting for demographics, insurance type, and hospital size.
Results:
Most patients (n=409) were treated at teaching hospitals. Patients in teaching hospitals had 2.09 times greater odds of prolonged LOS compared to those in non-teaching hospitals. Teaching status was not significantly associated with discharge disposition. Payer type, however, strongly influenced discharge outcomes: patients with self-pay or unknown insurance were more likely to be discharged with follow-up care, whereas those with government insurance had the lowest likelihood of follow-up after discharge.
Conclusions:
Teaching hospital status was associated with longer LOS for CVT patients but not with discharge disposition. Payer type significantly influenced discharge planning, underscoring the role of socioeconomic factors in post-acute care access. These findings highlight the need to address disparities in post-acute care planning for CVT patients.
10.1212/WNL.0000000000212812
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.