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The effect of hospital characteristics and organizational factors on pre- and postoperative lengths of hospital stay.

机译:医院特征和组织因素对住院时间前后的影响。

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摘要

To determine reasons for variations in length of stay (LOS) for surgical patients, a comprehensive statistical model was specified and estimated using 1978 discharge abstract data from New Jersey. The model distinguished preoperative LOS from postoperative LOS, and analyzed differences in the impacts of each determining factor on each segment of a hospital stay. The model included a large set of control variables, but the focus of discussion in this article is on factors which reflect the preferences, policies, and organizational routines of hospitals. The empirical findings suggest strategies that hospital managers and regulators can use for reducing average LOS. For example, afternoon admissions often result in extra preoperative days of care even after adjusting for severity of illness. Apparent scarcity of posthospital care in New Jersey also seems to translate into longer hospital stays. Using a comprehensive model and a large, reliable data set, the analysis confirms many hypotheses concerning reasons for LOS variation that have been suggested by earlier research. However, the analysis also raises questions concerning the interpretation of other earlier findings.
机译:为了确定外科手术患者住院天数(LOS)变化的原因,我们指定了一个综合统计模型,并使用1978年新泽西州的出院抽象数据进行了估算。该模型将术前LOS与术后LOS区别开来,并分析了每个决定因素对住院期间每个环节的影响的差异。该模型包括大量控制变量,但是本文的讨论重点是反映医院偏好,政策和组织惯例的因素。实证结果表明,医院管理者和监管者可以采用降低平均LOS的策略。例如,即使根据疾病的严重程度进行了调整,下午入院常常会导致额外的术前护理天数。新泽西州显然缺乏医院术后护理,这也意味着住院时间更长。使用一个全面的模型和一个庞大,可靠的数据集,该分析证实了先前研究提出的许多关于LOS变化原因的假设。但是,分析也提出了有关其他早期发现的解释的问题。

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