Stay A While, Or Not

Shorter hospital stay does not increase chance of returning to hospital among veterans

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Most people want to be in and out of the hospital as quickly as possible and not have to come back. This also holds true for veterans.

Over a 14-year period, the number of times veterans were readmitted to the hospital decreased, a recently published study has found. At the same time, staying a shorter time in the hospital didn't increase the chance of being readmitted.

Since the number of times patients are readmitted indicate how well they're being taken care of, it may be used as a financial incentive for hospitals in the future.

"Follow doctors’ orders after leaving the hospital."

Researchers, led by Peter Kaboli, MD, a professor, hospitalist and health services researcher at the Iowa City Veterans Affairs (VA) Medical Center, looked at more than 4 million medical admissions between 1997 and 2010 from almost 130 Veterans Affairs (VA) hospitals across the US to see how long patients stayed and whether they were readmitted.

Patients were over 45 years of age and over 97 percent of them were male. They had a variety of long-term conditions, including heart failure and chronic obstructive pulmonary disorder. Some had heart attacks, pneumonia, and gastrointestinal bleeding.

Researchers tracked patients' length of stay, illnesses and demographic information through the VA Patient Treatment File, which keeps records of patient admissions, diagnoses, procedures, the hospital units where they stayed and how they were discharged.

When looking at the number of readmissions to the hospital, researchers only included patients that went back within a month of the first hospital visit.

They found that the length of time patients were at the hospital decreased by a day and a half on average from just under five and a half days to about four days.

Across all conditions, the length of time spent in the hospital decreased. Those who had heart attacks or pneumonia had the greatest reduction in time spent at the hospital at almost three days and two days respectively.

Over the course of the study, the number of people readmitted to the hospital within 30 days of leaving decreased from 16.5 percent to 13.8 percent overall.

Heart attack readmissions decreased the most from 22.6 percent to 19.8 percent. COPD patients followed behind at 17.9 percent to 14.6 percent.

And the number of deaths three months after admission was reduced by 3 percent each year amongst all causes.

The length of a patient's hospital stay doesn't negatively affect the chance he or she will be readmitted, researchers said in their report.

"Overall trends in readmissions have decreased over 14 years, possibly due to improvements in hospital discharge procedures, increased access to post-discharge care, and improvements in hospital technology and preventive measures," researchers wrote.

"Nevertheless, many readmissions are preventable and opportunities for improvement exist."

Future research should look into how hospital readmission can be prevented and highlight which interventions can improve care for various high-risk conditions.

The authors note their study just looks at those in the Veterans Health Administration system, which doesn't take non-Veterans into account. They also do not know what measures patients took to prevent from being readmitted into the hospital.

The study, supported by the Office of Rural Health and the Health Services Research & Development Service, Veterans Health Administration and the US Department of Veterans Affairs, was published online December 17 in the Annals of Internal Medicine.

Reviewed by: 
Review Date: 
December 16, 2012
Last Updated:
December 19, 2012