Study finds length of stay critical factor in readmission rates at hospitals

September 07, 2017

An adequate length of stay during hospitalization is a critical factor in quality of care and a predictor of future readmission risk, according to a new study from The University of Texas at Dallas.

University researchers recently examined the deviation between hospital length of stay and guidelines mandated by the Centers for Medicare and Medicaid Services. Length of stay is a key component of health care costs that resonates across the health care system, affecting patients, health care providers and payers, such as Medicare and insurers. The United States leads developed nations in shorter hospital stays.

Dr. Zhiqiang "Eric" Zheng and Dr. Indranil R. Bardhan, professors of information systems in the Naveen Jindal School of Management, co-authored the paper, which was published in Production and Operations Management.

Using data from congestive heart failure patient records in North Texas from January 2006 to December 2009, they studied the relationship between length of stay and readmission risk, the role of health information technology (IT) in reducing the deviation of length of stay, and the cost trade-offs between early discharge and readmission.

Their results suggest that patients with hospital stays shorter than the guidelines by two or more days are likely to exhibit greater readmission risk, while patients whose length of stay exceeds the guidelines are likely to have a lower readmission risk.

"We show that if health care providers deviate from the mandated guidelines substantially, it results in significantly higher readmission risk, which is associated with higher dollars in terms of overall management of the patient," Bardhan said.

He noted that congestive heart failure is a chronic and very expensive disease.

"It needs long-term management," Bardhan said. "If you are able to keep patients away from the hospital and manage their care, you can bring down the costs dramatically."

The study indicates that the cost savings from early discharge is outweighed by the extra costs incurred from future readmission.

"There's a trade-off between saving now versus having higher costs later," Zheng said. "If you save a certain amount of money today by discharging a patient one day earlier, one month later the patient will have a 7.7 percent higher chance of coming back."

The study is one of the first to examine the relationship between the implementation of health IT and deviation from the guidelines of length of stay. The researchers found that the implementation of various health IT applications -- including electronic medical records -- helps reduce deviation.

They also found an association between patients who stick to the same hospital and a reduction in readmission risk.

The researchers said the study's results have significant implications for hospital executives, case managers and policymakers in terms of decision-making related to patient discharge planning and capacity utilization, and their effects on hospital quality.

"Hospitals are too focused on reducing length of stay," Zheng said. "They should be more forward-looking. Our paper tells a message that saving money by discharging patients now may not help hospitals save later. If you have to keep a patient a little longer this time, hospitals should not be penalized for doing that."
Dr. Jeong-ha "Cath" Oh of Georgia State University is a co-author of the paper.

About Readmission Rates

The readmission rate indicates the likelihood of being readmitted as an inpatient for the same principal diagnosis within 30 days of discharge from the previous visit.

The 30-day readmission risk became a central barometer of the Affordable Care Act to assess the quality of care delivery.

Since 2012, the Centers for Medicare and Medicaid Services has imposed penalties on hospitals for preventable readmissions related to chronic conditions such as congestive heart failure and pneumonia.

University of Texas at Dallas

Related Health Articles from Brightsurf:

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

New measure of social determinants of health may improve cardiovascular health assessment
The authors of this study developed a single risk score derived from multiple social determinants of health that predicts county-level cardiovascular disease mortality.

BU study: High deductible health plans are widening racial health gaps
The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

E-health resource improves men's health behaviours with or without fitness facilities
Men who regularly used a free web resource made significantly more health changes than men who did not, finds a new study from the University of British Columbia and Intensions Consulting.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.

Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.

Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.

Read More: Health News and Health Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to