Use of severity-adjusted length of stay to modify physician practice patterns.
OBJECTIVE
To compare inpatient length of stay among physicians by testing a new method for severity adjusting length of stay.


METHODS
A retrospective validation study with prospective follow-up after an intervention.


METHODS
A 531-bed community teaching hospital.


METHODS
Three hundred randomly selected patients from the 30,861 patients discharged in 1990.


METHODS
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.
Hackensack Medical Center, NJ 07601.
P A
PA
Gross
P E
PE
Yost-Cataruozolo
P
P
DeMauro
L
L
Passaglia
P
P
Eason
B
B
Hopkins
M
M
Fiallo
S
S
Wallenstein
J
J
Levine
J
J
Boscamp
D015897:Comorbidity; D006746:Hospital Bed Capacity, 500 and over; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D014481:United States