Hospital Length of Stay and Readmission: An Early Investigation

被引:50
作者
Carey, Kathleen [1 ]
Lin, Meng-Yun [1 ]
机构
[1] Boston Univ, Sch Publ Hlth, Boston, MA 02118 USA
基金
美国医疗保健研究与质量局;
关键词
hospitals; length of stay; readmissions; CONGESTIVE-HEART-FAILURE; PREDICTION; RATES; TRENDS;
D O I
10.1177/1077558713504998
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
This article is an investigation into the relationship between length of stay and readmission within 30 days of discharge from an acute care hospitalization. We estimated probability models for heart attack and for heart failure patients using generalized estimating techniques applied to hospital administrative data from California for calendar year 2008. The key independent variable was length of stay in the initial hospitalization. We found negative associations between length of stay and readmission probability, particularly in the case of heart attack. Simulated values of predicted readmissions based on a 1-day increase in length of stay yielded estimated reductions in readmission rates in the 7% to 18% range for heart attack patients and the 1% to 8% range for heart failure patients. Increasing length of stay for some patients may be a means of improving quality of care by reducing readmission during the 30-day postdischarge period.
引用
收藏
页码:99 / 111
页数:13
相关论文
共 27 条
[1]  
[Anonymous], 2007, REPORT C PROMOTING G, P103
[2]  
Bernard D.M., 2004, Adverse patient safety events: costs of readmissions and patient outcomes following discharge
[3]   Trends in Length of Stay and Short-term Outcomes Among Medicare Patients Hospitalized for Heart Failure, 1993-2006 [J].
Bueno, Hector ;
Ross, Joseph S. ;
Wang, Yun ;
Chen, Jersey ;
Vidan, Maria T. ;
Normand, Sharon-Lise T. ;
Curtis, Jeptha P. ;
Drye, Elizabeth E. ;
Lichtman, Judith H. ;
Keenan, Patricia S. ;
Kosiborod, Mikhail ;
Krumholz, Harlan M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2010, 303 (21) :2141-2147
[4]  
Carey K., 2002, Health Services Outcomes Research Methodology, V3, P41, DOI [10.1023/A:1021530924455, DOI 10.1023/A:1021530924455]
[5]   Posthospital medication discrepancies - Prevalence and contributing factors [J].
Coleman, EA ;
Smith, JD ;
Raha, D ;
Min, SJ .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (16) :1842-1847
[6]   The care transitions intervention - Results of a randomized controlled trial [J].
Coleman, Eric A. ;
Parry, Carla ;
Chalmers, Sandra ;
Min, Sung-joon .
ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (17) :1822-1828
[7]   How Health Care Reform Must Bend The Cost Curve [J].
Cutler, David .
HEALTH AFFAIRS, 2010, 29 (06) :1131-1135
[8]   CHANGES IN RATES OF UNSCHEDULED HOSPITAL READMISSIONS AND CHANGES IN EFFICIENCY FOLLOWING THE INTRODUCTION OF THE MEDICARE PROSPECTIVE PAYMENT SYSTEM - AN ANALYSIS USING RISK-ADJUSTED DATA [J].
DESHARNAIS, S ;
HOGAN, AJ ;
MCMAHON, LF ;
FLEMING, S .
EVALUATION & THE HEALTH PROFESSIONS, 1991, 14 (02) :228-252
[9]  
Encinosa W., 2005, ADV PATIENT SAFETY R, V1, P423
[10]   Revisiting Readmissions - Changing the Incentives for Shared Accountability [J].
Epstein, Arnold M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (14) :1457-1459