Trial reportJournal of general internal medicine2015
Increased Risk of Mortality among Patients Cared for by Physicians with Short Length-of-Stay Tendencies.
Trial report in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Frailty index and nutrition status impact perioperative outcomes in patients undergoing minimally invasive radical nephrectomy.Journal of robotic surgery · 2025Article
- Using clinical decision support through the electronic medical record to increase prescribing of high-dose parenteral thiamine in hospitalized patients with alcohol use disorder.Journal of substance abuse treatment · 2019Article
- Do Reduced Hospital Mortality Rates Lead to Increased Utilization of Inpatient Emergency Care? A Population-Based Cohort Study.Health services research · 2018Article
- Costs and Consequences of Early Hospital Discharge After Major Inpatient Surgery in Older Adults.JAMA surgery · 2017Article
- Newborn Length of Stay and Risk of Readmission.Paediatric and perinatal epidemiology · 2017Article
- Cost containment and patient well-being.Journal of general internal medicine · 2015Article
- Racial/Ethnic Disparities in Readmissions in US Hospitals: The Role of Insurance Coverage.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
2 authors.
Funding
Abstract
backgroundSince the introduction of the prospective payment system in 1983, U.S. hospitals have been financially incentivized to reduce inpatient length of stay, and average length of stay has shortened dramatically.
objectiveThe purpose of this study was to determine whether short length of stay is associated with worse patient outcomes.
designWe used a quasi-experimental design to compare the outcomes of admissions assigned to physicians with short versus long length-of-stay tendencies. We used each physician's mean length of stay to define their length of stay tendency. We then compared the outcomes of admissions assigned to physicians with short versus long length-of-stay tendencies in propensity score-matched and adjusted analyses using mixed-effects and conditional logistic regression models. PATIENTS: The study included all admissions for 10 common diagnoses among patients admitted to the medical teaching service of an urban academic hospital from 7/1/2002 through 6/30/2008. MAIN MEASURE: The primary outcome was 30-day mortality.
resultsWe examined 12,341 admissions among 79 physicians. After propensity score matching, admission groups were similar with respect to all demographic and clinical characteristics. Admissions of patients receiving care from short length-of-stay physicians were associated with significantly increased risk of 30-day mortality in adjusted (OR 1.43, 95 % CI: 1.11-1.85), propensity score-matched (OR 1.33, 95 % CI: 1.08-1.63), and matched and adjusted analyses (OR 1.36, 95 % CI: 0.98-1.90).
conclusionsPolicies that incentivize short length of stay may lead to worse patient outcomes. The financial benefits of shortening inpatient length of stay should be weighed against the potential harm to patients.
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