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Revisiting hospital length of stay: what matters?

OBJECTIVES
To explore actionable information that can be used to reduce hospital acute care length of stay (LOS) and to assess racial and income disparities in LOS in an integrated healthcare network.


STUDY DESIGN AND METHODS
Retrospective analysis of 8718 inpatients in an integrated healthcare network. The LOS was examined by using linear, log-linear, Poisson, generalized Poisson, and negative binomial (NB) models to control for confounding factors. The performances of the 5 models were compared, and the NB model was selected for the final analysis and report.


RESULTS
Over 50% of the inpatients were not married. The LOS was 22% longer for the unmarried patients compared with their married counterparts after controlling for confounding factors. No income or racial disparities were found.


CONCLUSIONS
The prolonged LOS of the unmarried patients and the potential lack of post discharge care support warrant greater attention from discharge planners at hospital level and from policy makers at both the national and local levels. Racial and income disparities are not unavoidable; the way in which care is paid for and delivered may play a role.