The increasing impact of length of stay 'outliers' on length of stay at an urban academic hospital
| العنوان: | The increasing impact of length of stay 'outliers' on length of stay at an urban academic hospital |
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| المؤلفون: | David Horrocks, Curtis Leung, Charles F. S. Locke, Melissa Richardson, Andrew H. Hughes, Ann M. Sheehy |
| المصدر: | BMC Health Services Research, Vol 21, Iss 1, Pp 1-7 (2021) BMC Health Services Research |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Summary data, Hospital resource utilization, Patient care, Health administration, Hospitals, Urban, parasitic diseases, medicine, Humans, Data reporting, health care economics and organizations, Retrospective Studies, business.industry, Research, Health Policy, Targeted interventions, Quality Improvement, Emergency medicine, Outlier, population characteristics, Length of stay, Public aspects of medicine, RA1-1270, Outlier length of stay, business, geographic locations, Healthcare system |
| الوصف: | Background As healthcare systems strive for efficiency, hospital “length of stay outliers” have the potential to significantly impact a hospital’s overall utilization. There is a tendency to exclude such “outlier” stays in local quality improvement and data reporting due to their assumed rare occurrence and disproportionate ability to skew mean and other summary data. This study sought to assess the influence of length of stay (LOS) outliers on inpatient length of stay and hospital capacity over a 5-year period at a large urban academic medical center. Methods From January 2014 through December 2019, 169,645 consecutive inpatient cases were analyzed and assigned an expected LOS based on national academic center benchmarks. Cases in the top 1% of national sample LOS by diagnosis were flagged as length of stay outliers. Results From 2014 to 2019, mean outlier LOS increased (40.98 to 45.11 days), as did inpatient LOS with outliers excluded (5.63 to 6.19 days). Outlier cases increased both in number (from 297 to 412) and as a percent of total discharges (0.98 to 1.56%), and outlier patient days increased from 6.7 to 9.8% of total inpatient plus observation days over the study period. Conclusions Outlier cases utilize a disproportionate and increasing share of hospital resources and available beds. The current tendency to exclude such outlier stays in data reporting due to assumed rare occurrence may need to be revisited. Outlier stays require distinct and targeted interventions to appropriately reduce length of stay to both improve patient care and maintain hospital capacity. |
| تدمد: | 1472-6963 |
| DOI: | 10.1186/s12913-021-06972-6 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e501d47713138957caa2ed14e935da69 https://doi.org/10.1186/s12913-021-06972-6 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e501d47713138957caa2ed14e935da69 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14726963 |
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| DOI: | 10.1186/s12913-021-06972-6 |