Have hospital readmissions increased in the face of reductions in length of stay? Evidence from England

Stephen Martin; Andrew Street; Lu Han; John Hutton

doi:10.1016/j.healthpol.2015.11.003

Have hospital readmissions increased in the face of reductions in length of stay? Evidence from England

Stephen Martin, Andrew Street, Lu Han, John Hutton

Research output: Contribution to journal › Article › peer-review

Abstract

We assess the relationship between changes in hospital length of stay (LoS) and hospital quality, as measured by 28-day emergency readmission. We estimate regression models to analyse LoS and other factors associated with readmission for all those admitted for hip replacement (n = 496,334), hernia repair (n = 413,712) or following a stroke (n = 480,113) in England between 2002/3 and 2007/8. There were reductions in LoS over time while changes in crude readmission rates varied by condition. Given the high mortality rate for stroke, it is critical to account for the probability of surviving the initial admission when evaluating readmissions. Conditional upon survival, the probability of readmission was greater for stroke patients who originally had a shorter LoS and for hernia patients who had an overnight stay but there is no relationship between LoS and readmission for patients who had hip replacement. The evidence does not generally suggest that reductions in LoS were associated with an increased probability of emergency readmission.

Original language	English
Pages (from-to)	89-99
Number of pages	11
Journal	Health Policy
Volume	120
Issue number	1
Early online date	17 Nov 2015
DOIs	https://doi.org/10.1016/j.healthpol.2015.11.003
Publication status	Published - Jan 2016

Keywords

English hospitals
Quicker and sicker
In-hospital mortality
Readmissions
Length of stay

Access to Document

10.1016/j.healthpol.2015.11.003

SM AS LH JH Hv hosp readmsns incrsd & reductns los Hlth Pol 120 1 89-99 2016Final published version, 533 KB

http://www.sciencedirect.com/science/article/pii/S0168851015002985

Cite this

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abstract = "We assess the relationship between changes in hospital length of stay (LoS) and hospital quality, as measured by 28-day emergency readmission. We estimate regression models to analyse LoS and other factors associated with readmission for all those admitted for hip replacement (n = 496,334), hernia repair (n = 413,712) or following a stroke (n = 480,113) in England between 2002/3 and 2007/8. There were reductions in LoS over time while changes in crude readmission rates varied by condition. Given the high mortality rate for stroke, it is critical to account for the probability of surviving the initial admission when evaluating readmissions. Conditional upon survival, the probability of readmission was greater for stroke patients who originally had a shorter LoS and for hernia patients who had an overnight stay but there is no relationship between LoS and readmission for patients who had hip replacement. The evidence does not generally suggest that reductions in LoS were associated with an increased probability of emergency readmission.",

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