Hospitals with briefer than average lengths of stays for common surgical procedures do not have greater odds of either re-admission or use of short-term care facilities

F Dexter; R H Epstein; E U Dexter; D A Lubarsky; E C Sun

doi:10.1177/0310057X1704500211

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Hospitals with briefer than average lengths of stays for common surgical procedures do not have greater odds of either re-admission or use of short-term care facilities

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Hospitals with briefer than average lengths of stays for common surgical procedures do not have greater odds of either re-admission or use of short-term care facilities

F Dexter, R H Epstein, E U Dexter, D A Lubarsky and E C Sun

Anaesthesia and intensive care, Vol.45(2), pp.210-219

03/2017

DOI: 10.1177/0310057X1704500211

PMID: 28267943

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Abstract

We considered whether senior hospital managers and department chairs need to be concerned that small reductions in average hospital length of stay (LOS) may be associated with greater rates of re-admission, use of home health care, and/or transfers to short-term care facilities. The 2013 United States Nationwide Readmissions Database was used to study surgical Diagnosis Related Groups (DRG) with 1) national median LOS ≥3 days and 2) ≥10 hospitals in the database that each had ≥100 discharges for the DRG. Dependent variables were considered individually: 1) re-admission within 30 days of discharge, 2) discharge disposition to home health care, and/or 3) discharge disposition of transfer to short-term care facility (i.e., inpatient rehabilitation hospital or skilled nursing facility). While controlling for DRG, each one-day decrease in hospital median LOS was associated with an odds of re-admission nationwide of 0.95 (95% confidence interval [CI] 0.92-0.99; =0.012), odds of disposition upon discharge being home care of 0.95 (95% CI 0.83-1.10; =0.64), and odds of transfer to short-term care facility of 0.68 (95% CI 0.54-0.85; =0.0008). Results were insensitive to the addition of patient-specific data. In the USA, patients at hospitals with briefer median LOS across multiple common surgical procedures did not have a greater risk for either hospital re-admission within 30 days of discharge or transfer to an inpatient rehabilitation hospital or a skilled nursing facility. The generalisable implication is that, across many surgical procedures, DRG-based financial incentives to shorten hospital stays seem not to influence post-acute care decisions.

Length of Stay

Rehabilitation Centers

Diagnosis-Related Groups

Skilled Nursing Facilities

Patient Readmission

Humans

Details

Title: Subtitle: Hospitals with briefer than average lengths of stays for common surgical procedures do not have greater odds of either re-admission or use of short-term care facilities
Creators: F Dexter - Professor and Director of the Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa, USA
R H Epstein - Professor, Department of Anesthesiology, University of Miami, Miami, Florida, USA
E U Dexter - Assistant Professor, Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA
D A Lubarsky - Professor and Chair, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Health System, Miami, Florida, USA
E C Sun - Instructor, Stanford University School of Medicine, Stanford, California, USA
Resource Type: Journal article
Publication Details: Anaesthesia and intensive care, Vol.45(2), pp.210-219
DOI: 10.1177/0310057X1704500211
PMID: 28267943
NLM abbreviation: Anaesth Intensive Care
ISSN: 0310-057X
eISSN: 1448-0271
Publisher: United States
Language: English
Date published: 03/2017
Academic Unit: Health Management and Policy; Anesthesia
Record Identifier: 9983806254002771

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