Use of severity-adjusted length of stay to modify physician practice patterns.

Autor:	Gross PA; Hackensack Medical Center, NJ 07601., Yost-Cataruozolo PE, DeMauro P, Passaglia L, Eason P, Hopkins B, Fiallo M, Wallenstein S, Levine J, Boscamp J
Jazyk:	angličtina
Zdroj:	Clinical performance and quality health care [Clin Perform Qual Health Care] 1993 Jan-Mar; Vol. 1 (1), pp. 23-8.
Abstrakt:	Objective: To compare inpatient length of stay among physicians by testing a new method for severity adjusting length of stay. Design: A retrospective validation study with prospective follow-up after an intervention. Setting: A 531-bed community teaching hospital. Patients: Three hundred randomly selected patients from the 30,861 patients discharged in 1990. Intervention: A physician with a significantly prolonged severity-adjusted length of stay was counseled and then monitored for three months. Results: The correlation between the number of comorbidities, complications, and manifestations of disease processes (CCMDPs) was R2 = 0.658, t = 23.96 (p = .001). One physician had an unusually high severity-adjusted length of stay, but lowered it after he was counseled and monitored for three months. Conclusions: The number of CCMDPs recorded on the hospital discharge abstract can be used as a severity index to adjust a patient's length of stay for illness severity. Using linear regression analysis, a picture of the severity-adjusted length of stay can be derived for physicians. Through counseling and monitoring, individual physicians' lengths of stay patterns may be reduced.
Databáze:	MEDLINE
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