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. 2021 Sep 20;4(9):e2125846. doi: 10.1001/jamanetworkopen.2021.25846

Table 1. Populations, Interventions, Comparators, Outcomes, Timing, Settings, and Inclusion and Exclusion Criteria.

Category Criteria
Population
  • Include hospitalized children and adults (including pregnant women) with ≥1 of the following risk factors for prolonged LOS, harms, or adverse outcomes:

  • High levels of socioeconomic risk (eg, housing instability, social isolation, social vulnerability, social mobility, lack of social network, lack of social support, limited access to health care services or social services, rural settings)

  • Medically uninsured, underinsured

  • Hospitalization at safety-net, tertiary, or quaternary care institution

  • Limited English proficiency

  • Patients who are medically complex, including those with comorbid psychiatric or behavioral health conditions, comorbid substance use disorder, frailty, multimorbidity (≥2 chronic health conditions), and high-volume chronic disease conditions with significant risk of exacerbation or complications (including chronic kidney disease, diabetes, congestive heart failure, and chronic obstructive pulmonary disease)

  • Exclude patients undergoing nonemergent or elective procedures

Interventions
  • Include interventions that are

  • Initiated within the hospital

  • Designed (at least in part) to evaluate LOS

  • Examples include but are not limited to clinical pathways, enhanced recovery programs, discharge planning, case management, and multidisciplinary teams

  • Exclude interventions that are

  • Initiated, managed, or implemented by entities wholly external to the hospital setting

  • Are not intended or expected to reduce LOS

  • Examples include but are not limited to ambulatory clinic follow-up visits, community-based support resources, regulatory policies, and third-party reimbursement programs

Comparators Include: Usual care, any comparison, or other active intervention
Outcomes
  • Include:

  1. Primary:

    • LOS

    • LOS index

  2. Secondary:

    • Readmission

    • Patient harms, such as mortality, hospital-acquired conditions

    • Patient experience or satisfaction

    • Patient functional return

    • Clinician or staff satisfaction

    • Resource use, including patient flow and discharge disposition

  • Exclude

  • Only describe cost-related outcomes without reporting LOS

  • Cost-related outcomes that do not quantify valuations of both comparisons or alternative interventions (including usual or standard care) and both of their associated outcomes

Timing Include: All
Setting
  • Include

  • Acute care hospitalizations in general or pediatric hospitals

  • Reviews of studies conducted in the United States

  • Exclude

  • Reviews focused solely on intensive care unit stays, emergency departments, or observation units

  • Specialty hospitals (eg, psychiatric, ophthalmologic, orthopedic, cancer, rehabilitation, long-term acute care)

  • Reviews of studies conducted solely outside the US

Abbreviation: LOS, length of stay.