A new study published this week in the Annals of Internal Medicine finds that efforts to reduce length of stay in hospitals do not necessarily lead to higher readmission rates, a longtime concern of some observers.

 

The study analyzed 14 years of records from the 129 Veterans Affairs acute care hospitals, finding that risk-adjusted mean length of stay declined by 1.46 days over that period, or roughly 2 percent annually, for five common diagnoses. During the same time frame, risk-adjusted, 30-day readmission rates for all medical diagnoses also declined, from 16.5 to 13 percent.

However, hospitals with lower-than-expected risk-adjusted length of stay did have higher readmission rates, which "suggested a modest trade-off" between hospital length of stay and readmission, wrote the researchers; with a hospital's experiencing a 6 percent increase for each full day its length of stay was lower than expected.

Among the other key findings:

  • During the time of the study, mortality rates 90 days after admission for any cause were reduced by 3 percent annually.
  • The study also found reductions in length of stay for all five diagnoses — heart failure, chronic obstructive pulmonary disease, acute myocardial infarction, community-acquired pneumonia and gastrointestinal hemorrhage.
  • Length of stay for acute myocardial infarction declined by 2.85 days, while readmission rates for that condition dropped from 22.6 to 19.8 percent.  For both measures, that marked the biggest reduction for all five conditions surveyed.

An abstract of the report is available here. This is the last H&HN Daily edition of 2012. Have a happy holiday and keep reading us in 2013.