Is length of stay in hospital a stable proxy for injury severity?

被引:26
作者
Cryer, C. [1 ]
Gulliver, P. [1 ]
Langley, J. D. [1 ]
Davie, G. [1 ]
机构
[1] Univ Otago, Sch Med, Dept Prevent & Social Med, Injury Prevent Res Unit, Dunedin, New Zealand
关键词
CARE;
D O I
10.1136/ip.2009.023903
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Research question Is length of stay (LoS) in hospital a stable proxy for severity of injury when monitoring time trends in serious injury incidence? Objective To investigate whether LoS metrics (mean, median and proportion exceeding several LoS thresholds) have changed over time for injury diagnoses with known severity. Design Time series investigation. Subjects and setting New Zealand population admitted to hospital for injury and discharged during the period 1989 to 1998. Main outcome measures Interpolated median and geometric mean lengths of stay, as well as the proportion of cases that have an LoS greater than or equal to 3, 4, 7 and 14 days in hospital. Methods ICD-9-CM diagnoses that are approximately homogeneous in regard to severity of injury (ICD-HS diagnoses) were identified. Trends were investigated in the LoS statistics for: injury and non-injury diagnoses combined; all injury diagnoses; major body sites of injury; severity strata; and ICD-HS diagnoses. Results Almost without exception, there was a decline in the LoS statistics over time for all diagnoses, all injury diagnoses, each body site of injury investigated, severity strata, and the ICD-HS diagnoses. Conclusions Reductions in median and geometric mean LoS over time, as well as reductions in the proportion exceeding selected LoS thresholds, were due to factors other than reductions in the incidence of serious injury; for example, changes in service delivery over time. An LoS threshold should not be used as a proxy for severity of injury if the goal is to monitor time trends in injury incidence.
引用
收藏
页码:254 / 260
页数:7
相关论文
共 16 条
  • [1] [Anonymous], 1999, Nonparametric Statistical Methods
  • [2] *ASS ADV AUT MED, 1990, ABBR INJ SCAL
  • [3] An introduction to the Barell body region by nature of injury diagnosis matrix
    Barell, V
    Aharonson-Daniel, L
    Fingerhut, LA
    Mackenzie, EJ
    Ziv, A
    Boyko, V
    Abargel, A
    Avitzour, M
    Heruti, R
    [J]. INJURY PREVENTION, 2002, 8 (02) : 91 - 96
  • [4] A new approach to outcome prediction in trauma: A comparison with the TRISS model
    Bouamra, Omar
    Wrotchford, Alan
    Hollis, Sally
    Vail, Andy
    Woodford, Maralyn
    Lecky, Fiona
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2006, 61 (03): : 701 - 710
  • [5] Length of stay - How short should hospital care be?
    Clarke, A
    Rosen, R
    [J]. EUROPEAN JOURNAL OF PUBLIC HEALTH, 2001, 11 (02) : 166 - 170
  • [6] Measure for measure: the quest for valid indicators of non-fatal injury incidence
    Cryer, C
    Langley, JD
    Stephenson, SCR
    Jarvis, SN
    Edwards, P
    [J]. PUBLIC HEALTH, 2002, 116 (05) : 257 - 262
  • [7] Accuracy of injury coding under ICD-9 for New Zealand public hospital discharges
    Langley, J
    Stephenson, S
    Thorpe, C
    Davie, G
    [J]. INJURY PREVENTION, 2006, 12 (01) : 58 - 61
  • [8] Traps for the unwary in estimating person based injury incidence using hospital discharge data
    Langley, J
    Stephenson, S
    Cryer, C
    Borman, B
    [J]. INJURY PREVENTION, 2002, 8 (04) : 332 - 337
  • [9] Last J., 1995, DICT EPIDEMIOLOGY, V3rd
  • [10] Mackenzie E., 1997, ICDMAP-90 Software: User's Guide, P1