Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals.
We did a retrospective study of 1920 episodes of community-acquired pneumonia (CAP) in 27 community hospitals and analysed inter-hospital variability in length of hospital stay (LOS), mortality and readmission rates. The overall adjusted LOS (mean+/-S.D.) was 10.0+/-9.8 days. LOS increased according to the Pneumonia Severity Index (PSI) risk class: 7.3 days for class I to 11.3 days for class V (P<0.001). In a multiple regression model, LOS increased (P<0.001) according to the hospital (inter-hospital variability), PSI risk class, complications during hospitalization, admission to ICU, need of oxygen and transfer to a nursing home. Hospitals with shorter LOS did not show an increased readmission rate (adjusted OR 1.02, 95% CI 0.51-2.03, P = 0.97) and post-discharge mortality (adjusted OR 1.20, 95% CI 0.70-2.05, P=0.51). There are significant inter-hospital variations in LOS in patients with CAP which are related to differences in clinical management. The reduction of these differences will further improve efficiency and quality of care.
Department of Internal Medicine, Hospital de Mataro, Consorci Sanitari del Maresme, Spain.
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Bolivar
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Pallares
D000368:Aged; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology