Hospital Length of Stay Reduction: A Long-Term Study

Ronald  Lagoe; Barbara  Drapola; Mary  Luziani; Louise  Pernisi

doi:10.4236/ijcm.2016.78058

Ronald Lagoe¹^*, Barbara Drapola², Mary Luziani³, Louise Pernisi⁴

Abstract: This study evaluated length of stay reduction for adult medicine and adult surgery in the combined hospitals of Syracuse, New York between 1998 and 2016. The study was based on the All Patients Refined Severity of Illness System. Through this approach, it controlled for changes in the degree of illness of hospital populations. The study data indicated that reductions in adult medicine and adult surgery stays in the Syracuse hospitals between 1998 and 2012 reduced the annual number of excess days compared with severity adjusted national averages by 49,000, or an average daily census of 134.2. It appeared that the shift to reimbursement by discharges initiated by Medicare was a major cause of these reductions. The impact of this change was accompanied by length of stay reduction initiatives by the Syracuse hospitals, especially relating to long-term care. Between January-April 2012 and 2016, additional reductions brought the lengths of stay for adult medicine and adult surgery in the combined Syracuse hospitals close to the national average. The study suggested that remaining opportunities for length of stay reductions in Syracuse involved patients with high severity of illness and those discharged to nursing homes.

Keywords: Hospitalization, Hospital Lengths of Stay, Hospital Reimbursement, Nursing Homes

Cite this paper: Lagoe, R. , Drapola, B. , Luziani, M. and Pernisi, L. (2016) Hospital Length of Stay Reduction: A Long-Term Study. International Journal of Clinical Medicine, 7, 530-537. doi: 10.4236/ijcm.2016.78058.

References

[1] Dentzler, S. (2011) Urgent Measures for an Old Problem. Health Affairs, 30, 1626.
http://dx.doi.org/10.1377/hlthaff.2011.0961

[2] Marcus, A. (2009) Bending the Curve: The Twists and Turns. Health Affairs, 28, 1256-1258.
http://dx.doi.org/10.1377/hlthaff.28.5.1256

[3] Friedman, B., De La Mare, J., Andrews, R. and McKenzie, D.H. (2002) Practical Options for Estimating the Costs of Hospital Stays. Journal of Health Care Finance, 29, 1-13.

[4] Cushing, W.T. (2004) Extra Hospital Days Can Cost You Plenty. Medical Economics, 81, 83.

[5] Fong, T. (2004) Medicaid under the Knife? Congress Considering Funding Cuts in Program? Modern Healthcare, 34, 6-7.

[6] Hoadley, J.F., Cunningham, P. and McHugh, M. (2004) Popular Medicaid Programs Do Battle with State Budget Pressures: Perspectives from Twelve States. Health Affairs, 23, 143-154.
http://dx.doi.org/10.1377/hlthaff.23.2.143

[7] Shah, B.R., Reed, S.D., Francis, J., Ridley, D.B. and Schulman, K.A. (2003) The Cost of Inefficiency in U.S. Hospitals, 1985-1987. Journal of Health Care Finance, 30, 1-9.

[8] Pena, A.D. and Ndiyae, M. (2002) Developing Hospital Efficiency Cost Control Measures. World Hospitals and Health Services, 38, 41-43.

[9] Marek, K.D. and Rantz, M.J. (2000) Aging in Place: A New Model for Long Term Care. Nursing Administration Quarterly, 24, 1-11.
http://dx.doi.org/10.1097/00006216-200004000-00003

[10] Weil, A.R. (2015) Hospital Cost and Quality. Health Affairs, 34, 1263.
http://dx.doi.org/10.1377/hlthaff.2015.0786

[11] Skinner, J., Chandra, A., Goodman, D. and Fisher, E.S. (2009) The Elusive Connection between Health Care Spending and Quality. Health Affairs, 28, w119-w123.
http://dx.doi.org/10.1377/hlthaff.28.1.w119

[12] Fuller, R.L., McCullough, E.C., Bao, M.Z. and Averill, R.F. (2009) Estimating the Costs of Potentially Preventable Hospital Acquired Complications. Health Care Financing Review, 30, 17-32.

[13] Gawande, A.A. (2011) The Hot Spotters: Can We Lower Costs by Getting the Neediest Patients Better Care? New Yorker.

[14] Hong, C.S., Siegel, A.L. and Ferris, T.G. (2014) Caring for High Need, High Cost Patients: What Makes for a Successful Care Management Program? Commonwealth Fund, New York.
http://dx.doi.org/10.15868/socialsector.25007

[15] Johnson, T.L., Rinehart, D.J., Durfee, J., Brewer, D., Batal, H., Blum, J., Oronce, C.J. and Melinkovich, P. (2015) For Many Patients Who Use Large Amounts of Health Services, the Need Is Intense Yet Temporary. Health Affairs, 34, 1312-1323.
http://dx.doi.org/10.1377/hlthaff.2014.1186

[16] Lagoe, R.J., Westert, G.P., Kendrick, K., Morreale, G. and Mnich, S. (2005) Managing Hospital Length of Stay Reduction: A Multihospital Approach. Health Care Management Review, 30, 89-92.
http://dx.doi.org/10.1097/00004010-200504000-00002

[17] Lagoe, R., Pasinski, T., Kronenberg, P., Quinn, T. and Schaengold, P. (2006) Linking Health Services at the Community Level. Canada Healthcare Quarterly, 9, 60-65.
http://dx.doi.org/10.12927/hcq..18229