U.S. Hospitals with an Average Length of Stay 15 Days or More for Respiratory Failure have a Readmission Rate of 36.08%, Over 7% Higher than the National Average
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By: Jeffrey Maser Jan. 04, 2018
A recent Dexur analysis of 2016 Medicare inpatient claims data from CMS discovered a 0.32 correlation between average length of stay and inpatient readmission rate for pulmonary edema and respiratory failure discharges. This finding indicates that average LOS and readmission rate have a weak, positive correlation for such discharges. Hospitals with an average LOS of more than 6.9 days for pulmonary edema or respiratory failure accounted for an inpatient readmission rate of 33.92%, while hospitals with an average LOS of under 4.05 days accounted for a readmission rate of 27.31%.
Analysts from Dexur examined Medicare discharge data between January - December 2016 for DRG-189, which represents pulmonary edema and respiratory failure. Hospitals with 11 or more DRG-189 readmissions were included in the analysis; 1,580 U.S. hospitals met this criteria. Along with the standard correlation test, Dexur analysts split the nearly 1,600 hospitals into five groups by average length of stay, with each group comprising of between 289 and 335 hospitals. The readmission rate for each hospital group decreased slightly as length of stay was reduced. Furthermore, hospitals with an average length of stay of 15 days or more for DRG-189 saw patients readmitted 36.08% of the time, which was 8.77% higher than the readmission rate for the lowest group of hospitals that was analyzed. Other research examining average LOS and readmission rates, such as this August 2017 study analyzing heart failure hospitalizations, have found that both excessively short and long length of stay can lead to higher readmission rates.
Altogether, the findings within this Dexur study indicate that hospitals with an excessively high length of stay for DRG-189 experienced more readmissions from patients. However, readmission rates do not decrease substantially once average length of stay reaches a certain threshold. A recent Dexur analysis in December on hip and knee replacement discharges similarly found that higher average length of stay was associated with higher readmission rates, although that study found larger gaps between readmission rates when hospitals were grouped by average length of stay.
| Average Readmission Rate for 5 Hospital Groups by Average Length of Stay for Pulmonary Edema and Respiratory Failure | ||||
|---|---|---|---|---|
| Average Hospital LOS (Days) | # of Hospitals in Group | Average Readmission Rate (%) | Average LOS for Hospital Group (Days) | Average Readmission Rate for Hospital Group (%) |
| All U.S. Hospitals | 1,580 | 28.98 | 6.50 | 28.98 |
| > 6.9 | 309 | 33.92 | 11.16 | 33.92 |
| 5.3 - 6.89 | 323 | 28.81 | 6.31 | 28.81 |
| 4.7 - 5.29 | 324 | 27.65 | 4.99 | 27.65 |
| 4.05 - 4.69 | 335 | 27.34 | 4.39 | 27.34 |
| <4.05 | 289 | 27.31 | 3.61 | 27.31 |
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