Hospital Length of Stay and Readmission Rate for Neurosurgical Patients

Shaheryar F. Ansari, Hong Yan, Jian Zou, Robert M. Worth, Nicholas Barbaro

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Hospital readmission rate has become a major indicator of quality of care, with penalties given to hospitals with high rates of readmission. At the same time, insurers are increasing pressure for greater efficiency and reduced costs, including decreasing hospital lengths of stay (LOS). OBJECTIVE: To analyze the authors'service to determine if there is a relationship between LOS and readmission rates. METHODS: Records of patients admitted to the authors' institution from October 2007 through June 2014were analyzed for several data points, including initial LOS, readmission occurrence, admitting and secondary diagnoses, and discharge disposition. RESULTS: Out of 9409 patient encounters, there were 925 readmissions. Average LOS was 6 d. Univariate analysis indicated a higher readmission rate with more diagnoses upon admission (P<.001) and an association between insurance type and readmission (P<.001), as well as decreasing average yearly LOS (P = .0045). Multivariate analysis indicated statistically significant associations between longer LOS (P = .03) and government insurance (P < .01). CONCLUSION: A decreasing LOS over time has been associated with an increasing readmission rate at the population level. However, at the individual level, a prolonged LOS was associated with a higher risk of readmission. This was attributed to patient comorbidities. However, this increasing readmission rate may represent many factors including patients' overall health status. Thus, the rate of readmission may represent a burden of illness rather than a valid metric for quality of care.

Original languageEnglish (US)
Pages (from-to)173-179
Number of pages7
JournalClinical Neurosurgery
Volume82
Issue number2
DOIs
StatePublished - Feb 1 2018

    Fingerprint

Keywords

  • Health care
  • Hospital costs
  • Patient readmissions
  • Quality indicators

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Ansari, S. F., Yan, H., Zou, J., Worth, R. M., & Barbaro, N. (2018). Hospital Length of Stay and Readmission Rate for Neurosurgical Patients. Clinical Neurosurgery, 82(2), 173-179. https://doi.org/10.1093/neuros/nyx160