PMID- 28267943
OWN - NLM
STAT- MEDLINE
DCOM- 20170619
LR  - 20190319
IS  - 0310-057X (Print)
IS  - 0310-057X (Linking)
VI  - 45
IP  - 2
DP  - 2017 Mar
TI  - Hospitals with briefer than average lengths of stays for common surgical 
      procedures do not have greater odds of either re-admission or use of short-term 
      care facilities.
PG  - 210-219
AB  - We considered whether senior hospital managers and department chairs need to be 
      concerned that small reductions in average hospital length of stay (LOS) may be 
      associated with greater rates of re-admission, use of home health care, and/or 
      transfers to short-term care facilities. The 2013 United States Nationwide 
      Readmissions Database was used to study surgical Diagnosis Related Groups (DRG) 
      with 1) national median LOS >/=3 days and 2) >/=10 hospitals in the database that 
      each had >/=100 discharges for the DRG. Dependent variables were considered 
      individually: 1) re-admission within 30 days of discharge, 2) discharge 
      disposition to home health care, and/or 3) discharge disposition of transfer to 
      short-term care facility (i.e., inpatient rehabilitation hospital or skilled 
      nursing facility). While controlling for DRG, each one-day decrease in hospital 
      median LOS was associated with an odds of re-admission nationwide of 0.95 (95% 
      confidence interval [CI] 0.92-0.99; P=0.012), odds of disposition upon discharge 
      being home care of 0.95 (95% CI 0.83-1.10; P=0.64), and odds of transfer to 
      short-term care facility of 0.68 (95% CI 0.54-0.85; P=0.0008). Results were 
      insensitive to the addition of patient-specific data. In the USA, patients at 
      hospitals with briefer median LOS across multiple common surgical procedures did 
      not have a greater risk for either hospital re-admission within 30 days of 
      discharge or transfer to an inpatient rehabilitation hospital or a skilled 
      nursing facility. The generalisable implication is that, across many surgical 
      procedures, DRG-based financial incentives to shorten hospital stays seem not to 
      influence post-acute care decisions.
FAU - Dexter, F
AU  - Dexter F
AD  - Professor and Director of the Division of Management Consulting, Department of 
      Anesthesia, University of Iowa, Iowa City, Iowa, USA.
FAU - Epstein, R H
AU  - Epstein RH
AD  - Professor, Department of Anesthesiology, University of Miami, Miami, Florida, 
      USA.
FAU - Dexter, E U
AU  - Dexter EU
AD  - Assistant Professor, Department of Thoracic Surgery, Roswell Park Cancer 
      Institute, Buffalo, New York, USA.
FAU - Lubarsky, D A
AU  - Lubarsky DA
AD  - Professor and Chair, Department of Anesthesiology, Perioperative Medicine and 
      Pain Management, University of Miami Health System, Miami, Florida, USA.
FAU - Sun, E C
AU  - Sun EC
AD  - Instructor, Stanford University School of Medicine, Stanford, California, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Anaesth Intensive Care
JT  - Anaesthesia and intensive care
JID - 0342017
SB  - IM
MH  - Diagnosis-Related Groups
MH  - Humans
MH  - *Length of Stay
MH  - *Patient Readmission
MH  - Rehabilitation Centers
MH  - *Skilled Nursing Facilities
OTO - NOTNLM
OT  - length of stay, re-admissions, home health care, short-term care facilities
EDAT- 2017/03/08 06:00
MHDA- 2017/06/20 06:00
CRDT- 2017/03/08 06:00
PHST- 2017/03/08 06:00 [entrez]
PHST- 2017/03/08 06:00 [pubmed]
PHST- 2017/06/20 06:00 [medline]
AID - 20160512 [pii]
AID - 10.1177/0310057X1704500211 [doi]
PST - ppublish
SO  - Anaesth Intensive Care. 2017 Mar;45(2):210-219. doi: 10.1177/0310057X1704500211.