Relation between length of hospital stay and costs of care for patients with community-acquired pneumonia.
OBJECTIVE
Patients with pneumonia often remain hospitalized after becoming clinically stable, without demonstrated benefits on outcome. The purposes of this study were to assess the relation between length of hospital stay and daily medical care costs and to estimate the potential cost savings associated with a reduced length of stay for patients with pneumonia.


METHODS
As part of a prospective study of adults hospitalized with community-acquired pneumonia at a community hospital and two university teaching hospitals, daily medical care costs were estimated by multiplying individual charges by department-specific cost-to-charge ratios obtained from each hospital's Medicare cost reports.


RESULTS
The median total cost of hospitalization for all 982 inpatients was $5, 942, with a median daily cost of $836, including $491 (59%) for room and $345 (41%) for non-room costs. Average daily non-room costs were 282% greater on the first hospital day, 59% greater on the second day, and 19% greater on the third day than the average daily cost throughout the hospitalization (all P <0.05), and were 14% to 72% lower on the last 3 days of hospitalization. Average daily room costs remained relatively constant throughout the hospital stay, with the exception of the day of discharge. A projected mean savings of $680 was associated with a 1-day reduction in length of stay.


CONCLUSIONS
Despite institutional differences in total costs, patterns of daily resource use throughout hospitalization were similar at all institutions. A 1-day reduction in length of stay might yield substantial cost-savings.
Fine
M J
MJ
Division of General Internal Medicine, Department of Medicine (MJF, DSO, WNK), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Pratt
H M
HM
Obrosky
D S
DS
Lave
J R
JR
McIntosh
L J
LJ
Singer
D E
DE
Coley
C M
CM
Kapoor
W N
WN
D000328:Adult; D000368:Aged; D001900:Boston; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000191:economics; D017046:Cost Savings / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009674:Nova Scotia; D010414:Pennsylvania; D011014:Pneumonia / Q000191:economics*; D017064:Process Assessment, Health Care; D012720:Severity of Illness Index