Length of stay and its impact on hospitals, physicians and patients : an economic perspective

Abstract

INTRODUCTION: Patient's inpatient Length of stay (LOS) is a frequently used metric in hospital medicine. Decreased in LOS has been correlated with lower risk of opportunistic infections and medication side effects [1]. In addition, improved outcomes of treatment with lower mortality rates are also associated with decreased LOS [1]. Thomas et al also believe that it indicates efficiency of hospitals [2]. Geometric LOS (GMLOS) is the number of days assigned to each hospitalized patient based on the admitting diagnosis. This is determined by diagnosis related group (DRG) which is basically the grouping of patients with similar diagnosis together. Medicare and Medicaid adhere to these DRG's to determine reimbursement rates to hospitals for the treatment they provide to patients. However, not every patient's hospital course follows a standard course and may not be discharged with in GMLOS. The cost of these extra day’s stay of the patient is paid by the hospital as per current healthcare reimbursement structure. Therefore, hospital administrations and physician’s goal are to have decreased patient LOS while providing optimal healthcare.