Shorter hospital stays don't compromise care, study finds

by Steven Reinberg, Healthday Reporter
Shorter hospital stays don't compromise care, study finds
Earlier discharge corresponds with lower readmission and death rates in VA hospitals.

(HealthDay)—Fears that patients are being forced out of hospitals dangerously early may be unfounded, researchers report.

Shorter hospital stays don't increase readmissions or lead to more deaths, according to a study of Veterans Administration hospitals.

Researchers from the Iowa City VA Medical Center looked at records for 129 VA hospitals across the United States, and found that lengths of stay decreased 27 percent over 14 years, or 2 percent annually. However, contrary to what they anticipated, readmission rates and also dropped during that time.

"What we found was that they both went down simultaneously. We can improve efficiency and at the same time improve 30-day ," said lead researcher Dr. Peter Kaboli, a .

"Over 14 years, the VA and other health care systems have been trying to improve efficiency, moving patients through the hospital quicker—get them diagnosed; get them treated; get them home," Kaboli explained.

"It's costly to be in the hospital, and patients prefer to go home," he added.

The study, published in the Dec. 18 issue of the , involved reviewing records for more than 4 million patients hospitalized between 1997 and 2010. The researchers paid special attention to patients with these five common health problems: , (COPD), , and gastrointestinal bleeding.

The researchers looked at length of stay and rate of readmissions in the 30 days and 90 days after hospital discharge. They also looked at the death rate one month and three months after .

While lengths of stay decreased 27 percent, readmissions rates decreased 16 percent, Kaboli said.

Moreover, death rates at 30 and 90 days after leaving the hospital dropped about 3 percent.

When patients were released too soon, however, the risk for readmission rose 6 percent for each day they were released early, Kaboli's group found.

Kaboli believes the positive results reflect improved coordination between hospital and outpatient services, and a focus on quality care and patient safety.

In addition, the greater use of hospitalists—doctors who provide care only in the hospital—is associated with higher quality care, he said.

Whether these same results are seen in private hospitals, where length of stay has also declined, isn't known, Kaboli said.

The authors of a commentary accompanying the study said the VA system has made some noteworthy advances.

"VA management has achieved some of the things health care reform is trying to achieve," said Dr. Eugene Oddone, co-author of the accompanying editorial who is with the Center for Health Services Research in Primary Care at the Durham Veterans Affairs Medical Center in North Carolina.

The VA system "can be used as a model for some aspects of health care reform," added Oddone, a professor of medicine at Duke University School of Medicine.

Specifically, he cited integration of care between the hospital and outpatient care, and improved quality of care.

More information: For more information on patient safety, visit the U.S. National Library of Medicine.

add to favorites email to friend print save as pdf

Related Stories

Deaths plague even top hospitals

Aug 08, 2011

More than 120 hospitals given top marks by patients for providing excellent care also have a darker distinction: high death rates for heart attack, heart failure or pneumonia, a USA Today analysis of new Medicare data ...

Recommended for you

New toilets for India's poor, crime-hit village

21 hours ago

More than 100 new toilets were unveiled Sunday in a poverty-stricken and scandal-hit village in northern India, where fearful and vulnerable women have long been forced to defecate in the open.

Can YouTube save your life?

Aug 29, 2014

Only a handful of CPR and basic life support (BLS) videos available on YouTube provide instructions which are consistent with recent health guidelines, according to a new study published in Emergency Medicine Australasia, the jo ...

Doctors frequently experience ethical dilemmas

Aug 29, 2014

(HealthDay)—For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

AMGA: Physician turnover still high in 2013

Aug 29, 2014

(HealthDay)—For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

Obese or overweight teens more likely to become smokers

Aug 29, 2014

A study examining whether overweight or obese teens are at higher risk for substance abuse finds both good and bad news: weight status has no correlation with alcohol or marijuana use but is linked to regular ...

User comments