• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of cmajCMAJ Information for AuthorsCMAJ Home Page
CMAJ. Mar 1, 1995; 152(5): 675–682.
PMCID: PMC1337615

Variation in length of stay as a measure of efficiency in Manitoba hospitals.

Abstract

OBJECTIVE: To examine the efficiency of Manitoba hospitals by analysing variations in length of stay for patients with similar characteristics. DESIGN: Retrospective study. Multiple regression analyses were used to adjust for patient (case-mix) characteristics and to identify differences in length of stay attributable to the hospital of admission for 14 specific, frequently encountered diagnostic categories and for all acute admissions. SETTING: The eight major acute care hospitals in Manitoba. PARTICIPANTS: Manitoba residents admitted to any one of the eight hospitals during the fiscal year 1989-90, 1990-91 or 1991-92. Patients transferred to or from another institution, those with atypically long stays and those who died in hospital were excluded. OUTCOME MEASURE: Length of hospital stay. RESULTS: The length of stay was strongly influenced by hospital of admission, even after adjustment for key patient characteristics. Excluding the most seriously ill patients and those with the longest stays, approximately 186 beds could potentially have been saved if each hospital had discharged its patients as efficiently as the hospital with the shortest overall length of stay. CONCLUSIONS: A substantial proportion of days currently invested in treating acute care patients could be eliminated. At least some bed closures in Manitoba hospitals could be accommodated simply through more efficient treatment of patients in the remaining beds, without decreasing access to hospital care.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cleary PD, Greenfield S, Mulley AG, Pauker SG, Schroeder SA, Wexler L, McNeil BJ. Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California. JAMA. 1991 Jul 3;266(1):73–79. [PubMed]
  • Manheim LM, Feinglass J, Shortell SM, Hughes EF. Regional variation in Medicare hospital mortality. Inquiry. 1992 Spring;29(1):55–66. [PubMed]
  • Roos LL, Jr, Roos NP, Cageorge SM, Nicol JP. How good are the data? Reliability of one health care data bank. Med Care. 1982 Mar;20(3):266–276. [PubMed]
  • Epstein AM, Stern RS, Weissman JS. Do the poor cost more? A multihospital study of patients' socioeconomic status and use of hospital resources. N Engl J Med. 1990 Apr 19;322(16):1122–1128. [PubMed]
  • McMahon LF, Jr, Hayward RA, Bernard AM, Rosevear JS, Weissfeld LA. APACHE-L: a new severity of illness adjuster for inpatient medical care. Med Care. 1992 May;30(5):445–452. [PubMed]
  • Iezzoni LI, Foley SM, Daley J, Hughes J, Fisher ES, Heeren T. Comorbidities, complications, and coding bias. Does the number of diagnosis codes matter in predicting in-hospital mortality? JAMA. 1992 Apr 22;267(16):2197–2203. [PubMed]
  • DesHarnais S, Hogan AJ, McMahon LF, Jr, Fleming S. Changes in rates of unscheduled hospital readmissions and changes in efficiency following the introduction of the Medicare prospective payment system. An analysis using risk-adjusted data. Eval Health Prof. 1991 Jun;14(2):228–252. [PubMed]
  • Manton KG, Woodbury MA, Vertrees JC, Stallard E. Use of Medicare services before and after introduction of the prospective payment system. Health Serv Res. 1993 Aug;28(3):269–292. [PMC free article] [PubMed]
  • Newhouse JP, Anderson G, Roos LL. Hospital spending in the United States and Canada: a comparison. Health Aff (Millwood) 1988 Winter;7(5):6–16. [PubMed]
  • Schieber GJ, Poullier JP, Greenwald LM. U.S. health expenditure performance: an international comparison and data update. Health Care Financ Rev. 1992 Summer;13(4):1–87. [PubMed]
  • Woolhandler S, Himmelstein DU. The deteriorating administrative efficiency of the U.S. health care system. N Engl J Med. 1991 May 2;324(18):1253–1258. [PubMed]
  • Redelmeier DA, Fuchs VR. Hospital expenditures in the United States and Canada. N Engl J Med. 1993 Mar 18;328(11):772–778. [PubMed]

Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...