Using length of stay data from a hospital to evaluate whether limiting elective surgery at the hospital is an inappropriate decision

Franklin Dexter, David Lubarsky

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Study objective At hospitals without detailed managerial accounting data but with overall longer than average diagnosis-related groups (DRG)-adjusted lengths of stays (LOS), some administrators do not aggressively hire the nurses needed to maintain surgical hospital capacity. The consequence of this (long-term) decision is that day-of-surgery admit cases are delayed or cancelled from a lack of beds. The anesthesiologists suffer financially. In this paper, we show how publicly released national LOS data can be applied specifically to these cases. Design We applied the method to 1 year of data from two academic hospitals. Each case's LOS was compared to the United States national average LOS for cases with the same DRG. Measurements and main results A total of 8,050 and 10,099 hospitalizations, respectively. Among all surgical admissions, mean LOS was 2.5 days longer than the national average for Hospital #1 (95% confidence interval [CI], 2.1 to 2.8) and 3.1 days longer for Hospital #2 (95% CI, 2.8 to 3.4). Among patients undergoing elective, scheduled surgery with day of surgery admission, mean LOS was 0.7 days less than average for Hospital #1 (0.6 to 0.9) and 1.2 days less than average for Hospital #2 (1.1 to 1.4). Conclusions This method can be used by anesthesiologists to show that LOS are not longer than average among patients whose surgeries may be cancelled or delayed for a lack of hospital ward staff.

Original languageEnglish (US)
Pages (from-to)421-425
Number of pages5
JournalJournal of Clinical Anesthesia
Volume16
Issue number6
DOIs
StatePublished - Sep 1 2004
Externally publishedYes

Fingerprint

Length of Stay
Diagnosis-Related Groups
Ambulatory Surgical Procedures
Confidence Intervals
Administrative Personnel
Hospitalization
Nurses

Keywords

  • Anesthesia department
  • financial management
  • hospital
  • length of stay
  • management
  • operating rooms
  • organization

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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title = "Using length of stay data from a hospital to evaluate whether limiting elective surgery at the hospital is an inappropriate decision",
abstract = "Study objective At hospitals without detailed managerial accounting data but with overall longer than average diagnosis-related groups (DRG)-adjusted lengths of stays (LOS), some administrators do not aggressively hire the nurses needed to maintain surgical hospital capacity. The consequence of this (long-term) decision is that day-of-surgery admit cases are delayed or cancelled from a lack of beds. The anesthesiologists suffer financially. In this paper, we show how publicly released national LOS data can be applied specifically to these cases. Design We applied the method to 1 year of data from two academic hospitals. Each case's LOS was compared to the United States national average LOS for cases with the same DRG. Measurements and main results A total of 8,050 and 10,099 hospitalizations, respectively. Among all surgical admissions, mean LOS was 2.5 days longer than the national average for Hospital #1 (95{\%} confidence interval [CI], 2.1 to 2.8) and 3.1 days longer for Hospital #2 (95{\%} CI, 2.8 to 3.4). Among patients undergoing elective, scheduled surgery with day of surgery admission, mean LOS was 0.7 days less than average for Hospital #1 (0.6 to 0.9) and 1.2 days less than average for Hospital #2 (1.1 to 1.4). Conclusions This method can be used by anesthesiologists to show that LOS are not longer than average among patients whose surgeries may be cancelled or delayed for a lack of hospital ward staff.",
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