Fifty ways to reduce length of stay: An inventory of how hospital staff would reduce the length of stay in their hospital

Borghans, Ine; Kool, Rudolf B; Lagoe, Ronald; Westert, Gert P.

doi:10.1016/j.healthpol.2011.12.010

Cited by 41 publications

(29 citation statements)

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“…The result of path analysis showed that there was a directly positive association between the length of stay toward patients' satisfaction of inpatient care in RSUD Dr. Moewardi, Surakarta and statistically approaching to significant. It is in accordance with the study conducted by Borghans et al, (2012) that states there is no correlation between length of stay and patients' satisfaction. Borghans et al, (2012) in his study does not find any evidence that hospital with relative shorter length of stay (LOS) owns higher level of satisfaction.…”

Section: Discussionsupporting

confidence: 91%

“…It is in accordance with the study conducted by Borghans et al, (2012) that states there is no correlation between length of stay and patients' satisfaction. Borghans et al, (2012) in his study does not find any evidence that hospital with relative shorter length of stay (LOS) owns higher level of satisfaction. Length of stay by considering physicall condition, type of diseases being suffered as well as the improvement in medication, is determined by hospital's medical team or doctor.…”

Section: Discussionsupporting

confidence: 91%

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The Influence of Personal Factors of the Patient, Doctor, Payment Method and Type of Class to the Quality and Satisfaction of Inpatient Care Services in Dr. Moewardi Hospital Surakarta

Akbar

Adriani²,

Murti

2017

J HEALTH POLICY MANAGE

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Background: The quality of hospital care is an important element in the implementation of healthcare service. The quality which is perceived is an assessment and a form of evaluation of healthcare users. Improvement on healthcare service is continually conducted to enhance the quality of service and patients' satisfaction. The study aimed to explain the influence of patients' personal factors, doctors, payment methods and types of class toward the quality and satisfaction of inpatient care. Subjects and Methods: This was an analytic observational study with cross-sectional design. This study was conducted at Dr. Moewardi Hospital, Surakarta, from March to April 2017. A total of 144 subjects were selected by stratified random sampling. Exogenous variables in this study were family income, level of education, length of stay, doctor's salary, the surgeon, type of insurance, and type of class. Endogenous variables were patient's satisfaction and quality of service. The data were collected by a set of questionnaires and secondary data of doctor's working period and salary. Data analyzed by path analysis. Results: Patient's satisfaction were affected by family income (b=-0.08; SE=0.48; p=0.093), level of education (b=-0.44; SE= 0.27; p= 0.102), length of stay (b=0.19; SE=0.99; p=0.059), doctor's salary (b= 0.02; SE=0.01; p=0.060), doctor's working period (b=0.99; SE=0.44; p=0.024), type of insurance (b= 0.72; SE=0.32; p=0.027), type of class (b= 2.11; SE=0.38; p<0.001), and quality of health services (b=0.16; SE=0.51; p=0.002). Quality of health services were affected by family income (b=-0.15; SE=0.07; p=0.039), length of stay (b=0.37; SE=0.15; p=0.017), doctor's working period (b= 0.13; SE=0.68; p=0.056), insurance types (b= 1.04; SE=0.50; p= 0.036), and type of class (b=2.24; SE=0.59; p<0.001). Conclusion: Patient's satisfaction are affected by family income, level of education, length of stay, doctor's salary, doctor's working period, type of insurance, type of class and quality of health services. Quality of health services are affected by family income, length of stay, doctor's working period, insurance types, and type of class.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

The Influence of Personal Factors of the Patient, Doctor, Payment Method and Type of Class to the Quality and Satisfaction of Inpatient Care Services in Dr. Moewardi Hospital Surakarta

Akbar

Adriani²,

Murti

2017

J HEALTH POLICY MANAGE

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“…Studies have confirmed that duration of hospital stay is regarded as an indicator of efficiency. [1][2][3][4] For low dependency inpatients, a long hospital stay may imply ineffective treatment, which increases healthcare expenditure. Theoretically, reducing duration of stay may increase the capacity of available hospital beds and the admissions of new inpatients.…”

Section: Introductionmentioning

confidence: 99%

What makes the hospitalisation system more efficient? An application of the decomposition method to Hong Kong morbidity data

et al. 2014

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ObjectiveTo examine the efficiency of the Hong Kong hospitalisation system based on hospitalisation days.DesignRetrospective study.SettingHospitalisation data (2000–2010) for all government-funded hospitals in Hong Kong.PopulationHospitalisation data for the entire Hong Kong population (7.0 million in 2011).MethodsA decomposition method was used to determine the effects on total hospitalisation days during the period 2000–2010 of the following three factors: (i) hospitalisation rate per person; (ii) the number of visits per patient; and (iii) the mean duration of stay per visit.Main outcome measuresThe decomposition method provides empirical measures of how the three factors contributed to the change in total hospitalisation days during the period 2000–2010 and identifies the most effective way to contain increases in hospitalisation days.ResultsThe results of decomposition analysis show that the decrease in mean duration of stay per visit (reducing from 6.83 to 4.58 days) is the most important factor in the reduction in the total number of hospitalisation days, despite increases in total population size (from 6.7 to 7.0 million), the number of individual hospital admissions (from 583 000 to 664 000) and the number of episodes (from 1.2 to 1.4 million) from 2000 to 2010. Hospitalisation days per person decreased from 1.18 in 2000 to 0.93 in 2010. The decline in the mean duration of stay per visit contributed 200.6% to this reduction but was offset by −51.1% due to a slight growth in the number of visits per patient and by −49.4% as a result of changed hospitalisation rates per person.ConclusionsBetter management of the duration of stay of per visit without compromising patient satisfaction levels or the quality of service is the most important factor for controlling increases in health expenditure in Hong Kong.

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“…The introduction of a per diem payment system in Japan led immediately to a decline of the ALOS nationally (MHLW, ), as predicted by models on hospital behavior and suggested by empirical evidence in other countries (Suthummanon and Omachonu, ; Laffont and Tirole, ; Rosko and Broyles, ). A number of Japanese hospitals use classic measures to shorten ALOS by raising the efficiency of medical treatment (Borghans et al ., ; Besstremyannaya, ; Kuwabara et al ., ; Suwabe, ). However, both technical and cost efficiency of Japanese local public hospitals show only a minor improvement following the reform (Besstremyannaya, ), and the impact on hospital costs is ambiguous (Nishioka, ; Yasunaga et al ., ; Yasunaga et al ., ).…”

Section: Per Diem Payment System In Japanmentioning

confidence: 99%

Differential Effects of Declining Rates in a Per Diem Payment System

Besstremyannaya

2014

Health Economics

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The paper demonstrates differential effects of a prospective payment system with declining per diem rates, dependent on the percentiles of length of stay. The analysis uses dynamic panel data estimates and a recent nationwide administrative database for major diagnostic categories in 1068 Japanese hospitals in 2006-2012 to show that average length of stay significantly increases for hospitals in percentiles 0-25 of the pre-reform length of stay and significantly decreases for hospitals in percentiles 51-100. The decline of the average length of stay is larger for hospitals in higher percentiles of the length of stay. Hospitals in percentiles 51-100 significantly increase their rate of nonemergency/unanticipated readmissions within 42 days after discharge. The decline in the length of total episode of treatment is smaller for hospitals in percentiles 0-25. The findings are robust in terms of the choice of a cohort of hospitals joining the reform. The paper discusses applicability of 'best practice' rate-setting to help improve the performance of hospitals in the lowest quartile of average length of stay. Copyright © 2015 John Wiley & Sons, Ltd.

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Fifty ways to reduce length of stay: An inventory of how hospital staff would reduce the length of stay in their hospital

Cited by 41 publications

References 95 publications

The Influence of Personal Factors of the Patient, Doctor, Payment Method and Type of Class to the Quality and Satisfaction of Inpatient Care Services in Dr. Moewardi Hospital Surakarta

The Influence of Personal Factors of the Patient, Doctor, Payment Method and Type of Class to the Quality and Satisfaction of Inpatient Care Services in Dr. Moewardi Hospital Surakarta

What makes the hospitalisation system more efficient? An application of the decomposition method to Hong Kong morbidity data

Differential Effects of Declining Rates in a Per Diem Payment System

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