Medicaid, non-home discharge tied to longer hospital stays

(HealthDay)—Prolonged hospital length of stay (LOS) is more likely among patients who are Medicaid enrollees with complex hospital stays who were not discharged home, according to a study published in the September issue of the Journal of Hospital Medicine.

Mary E. Anderson, M.D., from the University of Colorado in Aurora, and colleagues retrospectively evaluated administrative discharge data (2012 to 2014) to characterize predictors of prolonged hospitalizations (>21 days) among general medicine patients.

The researchers found that of 18,363 discharges, 2.3 percent had prolonged LOS (18.6 percent of total inpatient days). Younger age (odds ratio [OR], 0.8 per 10-year increase in age) and Medicaid insurance (OR, 1.99) were associated with prolonged hospitalizations. Prolonged LOS patients were more likely to have methicillin-resistant Staphylococcus aureus septicemia (OR, 8.83); require a palliative care consult (OR, 4.63), ICU stay (OR, 6.66), or surgery (OR, 5.04); and be discharged to a postacute-care facility (OR, 10.37) compared with patients without prolonged LOS.

"Prolonged hospitalizations in a small proportion of patients were an important contributor to overall LOS and particularly affected Medicaid enrollees with complex hospital stays who were not discharged home," the authors write.

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