By: Jeffrey Maser  Apr. 13, 2018
A Dexur study of Medicare inpatient claims data from CMS indicates that Three Rivers Medical Center in Louisa had the lowest average length of stay for a 30-day episode of care with unplanned readmissions for cellulitis discharges among Kentucky hospitals at 3.06 days between 2013-2016. This was over a day and a half lower than the national average of 4.81 days as well as the 4.68 day average for Kentucky Medicare enrollees. Kentucky River Medical Center in Jackson ranked close behind in 2nd at 3.09 days. Manchester Memorial Hospital, located in Manchester, ranked 3rd at 3.26 days while St. Claire Regional Medical Center in Morehead ranked 4th at 3.37 days. Harrison Memorial Hospital in Cynthiana rounded out the top five with a 3.39 day average LOS for a 30-day episode of care with unplanned readmissions.
The average LOS measure for a 30-day episode of care with unplanned readmissions is comprised of index hospital LOS along with any other days spent in the hospital in the first 30 days post-discharge due to unplanned readmissions. An unplanned readmission is defined as a hospital readmission via the emergency department. It must be understood, however, that patients are not always readmitted to the index hospital for subsequent stays. Hospitals in Kentucky were included in the rankings if they accounted for at least 50 DRG-603 (Cellulitis Without Major Complication or Comorbidity) discharges between January 2013 - December 2016; 67 hospitals met this criteria. Discharges where the patient expired, was transferred, or was discharged against medical advice were excluded from the totals. DRG-603 was selected specifically for the analysis as it is the highest volume DRG within skin infections. DRG-602 (Cellulitis With Major Complication or Comorbidity) is the only other diagnosis related group within this condition. During the analyzed time frame, 668,554 skin infection discharges were accounted for by U.S. Medicare enrollees, 547,861 (82%) of which were attributed to DRG-603.
Along with accounting for the lowest-in-state average LOS for a 30-day episode of care with unplanned readmissions, Three Rivers Medical Center also had the lowest average LOS for a 30-day episode of care including both unplanned as well as planned readmissions. The hospital’s 3.23 day rate was more than 2 days lower than both the national and state averages of 5.39 and 5.27 days, respectively. A major contributor to Three Rivers Medical Center’s top rank for both 30-day episode of care metrics was the hospital’s average LOS for the index hospital stay of 2.77 days. This ranked 3rd among the analyzed facilities and was roughly 1.4 days lower than both the national and state averages.