Computer-generated informational messages directed to physicians: effect on length of hospital stay.
OBJECTIVE
With the advent of hospital payment by diagnosis-related group (DRG), length of stay (LOS) has become a major issue in hospital efforts to control costs. Because the Columbia-Presbyterian Medical Center (CPMC) has had above-average LOSs for many DRGs, the authors tested the hypothesis that a computer-generated informational message directed to physicians would shorten LOS.


METHODS
Randomized clinical trial with the patient as the unit of randomization.


METHODS
From June 1991 to April 1993, at CPMC in New York, 7,109 patient admissions were randomly assigned to an intervention (informational message) group and 6,990 to a control (no message) group.


METHODS
A message giving the average LOS for the patient's admission or provisional DRG, as assigned by hospital utilization review, and the current LOS, in days, was included in the main menu for review of test results in the hospital's clinical information system, available at all nursing stations in the hospital.


METHODS
Hospital LOS.


RESULTS
The median LOS for study patients was 7 days. After adjustment for covariates including age, sex, payor, patient care unit, and time trends, the mean LOS in the intervention group was 3.2% shorter than that in the control group (p = 0.022).


CONCLUSIONS
Computer-generated patient-specific LOS information directed to physicians was associated with a reduction in hospital LOS.
Shea
S
S
Department of Medicine, Columbia University, New York, NY.
Sideli
R V
RV
DuMouchel
W
W
Pulver
G
G
Arons
R R
RR
Clayton
P D
PD
D000704:Analysis of Variance; D003363:Cost Control / Q000379:methods; D003953:Diagnosis-Related Groups; D006751:Hospital Information Systems; D006801:Humans; D007902:Length of Stay; D010820:Physicians; D015397:Program Evaluation / Q000379:methods; D014600:Utilization Review