Optimizing Hospital Length to Control Costs

Optimizing the length of stay at a hospital is critical to patient health outcomes, and more importantly, controlling healthcare costs. Current statistics show that nearly 1 out of every 5 dollars goes to healthcare, while hospitals account for almost one third of those costs. An estimated $700 billion is spent each year on care that has no link to improving health outcomes, and most of that care occurs during hospitalizations.

“At my hospital, we have reduced lengths of stay by about 11% over the last 2 years by changing how we practice medicine, and the changes have also improved outcomes for patients. We've gotten better at coordinating diagnostic testing and evaluations, responding quicker to infections, engaging in smarter treatment planning from pre-admission to post-discharge, and we're better at educating patients to prevent complications during recovery,” Dr Glenn Braunstein, VP of clinical innovation at Cedars-Sinai Medical Centers, said in a recent article. “Such efforts offer a glimpse into the future of medicine as physicians and hospitals strive to deliver more efficient and higher-quality medical care, one of the cornerstones of the Affordable Care Act. Already, Medicare and insurance companies are taking steps to shift incentives from rewarding quantity of care to rewarding quality and keeping people healthy. Inappropriate hospitalizations will risk penalties under government-sponsored insurance programs.”

Needless screenings, unrequired procedures, and lengthy patient monitoring should all be avoided to make hospital care more efficient. Sometimes physicians may delay discharge “just in case,” or may comply to a patient’s request for extra time under hospital supervision. However, Dr Braunstein says these are only a few of the reasons changes to the payment system are needed. Incentives would encourage physicians and other providers to deliver more responsible and cost-effective care.

"We have a responsibility to avoid these situations. When patients are deemed stable, they should be discharged to their homes or nursing facilities,” said Dr Braunstein. “Patients should feel confident that their hospital teams have done everything possible to prepare them for recovery. It's smart medicine and the right thing to do.”

Around the Web

Hospital Stays: When Less Medicine is More [Los Angeles Times]