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Shorter Hospital Stays, More Nursing Home Stays

Wed, 12/20/2000 - 12:00am — Karen Stevenson
Description: 

Older patients hospitalized with pneumonia for an increasingly shorter length of time are more likely to be re-admitted or discharged to a nursing home, a study by a Yale researcher and collaborators shows. This is important because the length of hospital stays is declining nationwide. Pneumonia among older patients is responsible for more than 600,000 hospitalizations nationally and $9 billion in health care costs every year. About 10% of patients older than 64 who are hospitalized with pneumonia die while hospitalized. Many more die within a month of being discharged. Of those patients who do survive, about 12% require placement in a long-term care or rehabilitation facility.

Meehan and his co-researchers looked at patients over 65 who were discharged from Connecticut hospitals between Oct. 1, 1991 to Sept. 30, 1997, after being treated for pneumonia. In that six-year period, the average length of stay for these patients dropped by about 4 days. They found that the mortality rates during the patients' hospital stays declined, because they were there for a much briefer period of time, but:

* The percentage of patients transferred to long term care facilities increased from 30% to 43%.

* The rate of mortality within 30 days after discharge increased from 7% to 9%.

* Re-admissions to the hospital for pneumonia within 30 days of discharge increased from 3% to 4%.

The mean adjusted costs associated with hospitalization for pneumonia declined steadily over the five year period from $9,228 to $6,897. The next study they plan will look at the total cost to the healthcare system when you factor in rates of re-admission and transfer to long term care facilities.

The principal investigator of the study was Mark Metersky, M.D., of the University of Connecticut School of Medicine. Co-authors included Michael Fine, M.D., of the University of Pittsburgh School of Medicine; and Janet Tate, MPH, and Marcia Petrillo, MA, of Qualidigm, a quality improvement organization based in Middletown. Metersky and Meehan also are affiliated with Qualidigm.

Older patients hospitalized with pneumonia for an increasingly shorter length of time are more likely to be re-admitted or discharged to a nursing home, a study by a Yale researcher and collaborators shows. This is important because the length of hospital stays is declining nationwide. Pneumonia among older patients is responsible for more than 600,000 hospitalizations nationally and $9 billion in health care costs every year. About 10% of patients older than 64 who are hospitalized with pneumonia die while hospitalized. Many more die within a month of being discharged. Of those patients who do survive, about 12% require placement in a long-term care or rehabilitation facility.

Meehan and his co-researchers looked at patients over 65 who were discharged from Connecticut hospitals between Oct. 1, 1991 to Sept. 30, 1997, after being treated for pneumonia. In that six-year period, the average length of stay for these patients dropped by about 4 days. They found that the mortality rates during the patients' hospital stays declined, because they were there for a much briefer period of time, but:

* The percentage of patients transferred to long term care facilities increased from 30% to 43%.

* The rate of mortality within 30 days after discharge increased from 7% to 9%.

* Re-admissions to the hospital for pneumonia within 30 days of discharge increased from 3% to 4%.

The mean adjusted costs associated with hospitalization for pneumonia declined steadily over the five year period from $9,228 to $6,897. The next study they plan will look at the total cost to the healthcare system when you factor in rates of re-admission and transfer to long term care facilities.

The principal investigator of the study was Mark Metersky, M.D., of the University of Connecticut School of Medicine. Co-authors included Michael Fine, M.D., of the University of Pittsburgh School of Medicine; and Janet Tate, MPH, and Marcia Petrillo, MA, of Qualidigm, a quality improvement organization based in Middletown. Metersky and Meehan also are affiliated with Qualidigm.