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Eur J Intern Med. 2015 Dec;26(10):772-5. doi: 10.1016/j.ejim.2015.10.011. Epub 2015 Nov 10.

Prolonged length of stay in hospitalized internal medicine patients.

Author information

1
Department of Internal Medicine, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain. Electronic address: raquel.barba@hospitalreyjuancarlos.es.
2
Department of Internal Medicine, Hospital Clínico de San Carlos, Madrid, Spain. Electronic address: javier.marco@elmundo.es.
3
Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain. Electronic address: jcanora.hflr@salud.madrid.org.
4
Department of Internal Medicine, Hospital Severo Ochoa, Leganés, Madrid, Spain. Electronic address: splaza.hsvo@salud.madrid.org.
5
Department of Internal Medicine, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain. Electronic address: sara.nistal@hospitalreyjuancalos.es.
6
Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain. Electronic address: jhinojosa.hflr@salud.madrid.org.
7
Department of Internal Medicine, Hospital Clínico de San Carlos, Madrid, Spain. Electronic address: manuel.mendez@salud.madrid.org.
8
Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain. Electronic address: azapatero.hflr@salud.madrid.org.

Abstract

BACKGROUND:

Targeting patients with prolonged hospitalizations may represent an effective strategy for reducing average hospital length of stay (LOS).

OBJECTIVE:

We sought to characterize predictors of prolonged hospitalization among internal medicine patients in an effort to guide future improvement efforts.

DESIGN:

We conducted a retrospective cohort study using administrative data of internal medicine patients from all hospitals of the Spanish Public Health Service between January 1st, 2005 and December 31st, 2013. Multivariable logistic regression was performed to assess the association between sociodemographic and clinical variables and prolonged LOS, defined as >30days.

KEY RESULTS:

Of 5,275,139 discharges, 166,470 (3.2%) had a prolonged LOS. Prolonged hospitalizations accounted for 17.4% of total inpatient days and contributed 0.5days to an average LOS of 9.8days during the study period. Prolonged hospitalizations were associated with younger age (odds ratio [OR]: 0.97 per 10-year increase in age, 95% confidence interval [CI]: 0.96-0.98) and male gender (OR 0.88 IC95% 0.87-0.89). Compared to patients without prolonged LOS, prolonged LOS patients were more likely to require a palliative care consult (OR: 2.48, 95% CI: 2.39-2.58), surgery (OR: 6.9 95% CI: 6.8-7.0); and be discharged to a post-acute-care facility (OR: 2.91, 95% CI: 2.86-2.95).

CONCLUSIONS:

Prolonged hospitalizations in a small proportion of patients were an important contributor to overall LOS and particularly affected complex hospital stays who were not discharged home.

KEYWORDS:

Administrative data; Hospital length of stay; Medical patients

PMID:
26563937
DOI:
10.1016/j.ejim.2015.10.011
[Indexed for MEDLINE]

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