Conditional Length of Stay

To develop and test a new outcome measure, Conditional Length of Stay (CLOS), to assess hospital performance when deaths are rare and complication data are not available. The 1991 and 1992 MedisGroups National Comparative Data Base. We use engineering reliability theory traditionally applied to esti...

Full description

Saved in:
Bibliographic Details
Published in:Health services research 1999-04, Vol.34 (1 Pt 2), p.349-363
Main Authors: Silber, J H, Rosenbaum, P R, Koziol, L F, Sutaria, N, Marsh, R R, Even-Shoshan, O
Format: Article
Language:English
Subjects:
Adjustment
Administration
AIDS/HIV
Appendectomy
Appendectomy - adverse effects
Appendectomy - statistics & numerical data
Child
Chronic Disease
Clinical outcomes
Cost control
Cross infection
Health care
Hospital administration
Hospital stays
Hospital utilization
Hospitalization
Hospitals
Hospitals, Pediatric - standards
Hospitals, Pediatric - utilization
Humans
Length of stay
Length of Stay - statistics & numerical data
Mortality
Nosocomial infections
Outcome Assessment (Health Care) - methods
Outcome Assessment (Health Care) - statistics & numerical data
Patient Discharge - statistics & numerical data
Patients
Pediatrics
Philadelphia
Pneumonia
Pneumonia - complications
Postoperative Complications
Proportional Hazards Models
Prospective payment systems
Quality Indicators, Health Care
Statistical analysis
Statistical methods
Statistics, Nonparametric
Studies
Time Factors
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To develop and test a new outcome measure, Conditional Length of Stay (CLOS), to assess hospital performance when deaths are rare and complication data are not available. The 1991 and 1992 MedisGroups National Comparative Data Base. We use engineering reliability theory traditionally applied to estimate mechanical failure rates to construct a CLOS measure. Specifically, we use the Hollander-Proschan statistic to test if LOS distributions display an "extended" pattern of decreasing hazards after a transition point, suggesting that "the longer a patient has stayed in the hospital, the longer a patient will likely stay in the hospital" versus an alternative possibility that "the longer a patient has stayed in the hospital, the faster a patient will likely be discharged from the hospital." Abstracted records from 7,777 pediatric pneumonia cases and 3,413 pediatric appendectomy cases were available for analysis. For both conditions, the Hollander-Proschan statistic strongly displays an "extended" pattern of LOS by day 3 (p
ISSN:0017-9124
1475-6773