RESUMEN
Acknowledging the necessity of a division of labour between hospitals and social care services regarding treatment and care of patients with chronic and complex conditions, is to acknowledge the potential conflict of interests between health care providers. A potentially important conflict is that hospitals prefer comparatively short length of stay (LOS) at hospital, while social care services prefer longer LOS all else equal. Furthermore, inappropriately delayed discharges from hospital, i.e. bed blocking, is costly for society. Our aim is to discuss which factors that may influence bed blocking and to quantify bed blocking costs using individual Norwegian patient data, merged with social care and hospital data. The data allow us to divide hospital LOS into length of appropriate stay (LAS) and length of delay (LOD), the bed blocking period. We find that additional resources allocated to social care services contribute to shorten LOD indicating that social care services may exploit hospital resources as a buffer for insufficient capacity. LAS increases as medical complexity increases indicating hospitals incentives to reduce LOS are softened by considerations related to patients' medical needs. Bed blocking costs constitute a relatively large share of the total costs of inpatient care.
Asunto(s)
Hospitalización/economía , Tiempo de Internación/economía , Alta del Paciente , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Modelos Econométricos , Noruega , Análisis de Regresión , Factores de TiempoRESUMEN
Three new acylated spermidines and two known related compounds were isolated from the Okinawan soft coral, Sinularia sp. These compounds were N',N",N"-trimethylspermidines that are acylated by a methyl-branched unsaturated fatty acid. These acylspermidines showed potent cytotoxicity against human tumor cell lines at an IC(50) value of 17 ng/ml and the induction of apoptotic phenomena.