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Have hospital readmissions increased in the face of reductions in length of stay? Evidence from England

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  • Martin, Stephen
  • Street, Andrew
  • Han, Lu
  • Hutton, John

Abstract

We assess the relationship between changes in hospital length of stay (LoS) and hospital quality, as measured by 28-day emergency readmission. We estimate regression models to analyse LoS and other factors associated with readmission for all those admitted for hip replacement (n=496,334), hernia repair (n=413,712) or following a stroke (n=480,113) in England between 2002/3 and 2007/8. There were reductions in LoS over time while changes in crude readmission rates varied by condition. Given the high mortality rate for stroke, it is critical to account for the probability of surviving the initial admission when evaluating readmissions. Conditional upon survival, the probability of readmission was greater for stroke patients who originally had a shorter LoS and for hernia patients who had an overnight stay but there is no relationship between LoS and readmission for patients who had hip replacement. The evidence does not generally suggest that reductions in LoS were associated with an increased probability of emergency readmission.

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  • Martin, Stephen & Street, Andrew & Han, Lu & Hutton, John, 2016. "Have hospital readmissions increased in the face of reductions in length of stay? Evidence from England," Health Policy, Elsevier, vol. 120(1), pages 89-99.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:1:p:89-99
    DOI: 10.1016/j.healthpol.2015.11.003
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    References listed on IDEAS

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    1. Laudicella, Mauro & Li Donni, Paolo & Smith, Peter C., 2013. "Hospital readmission rates: Signal of failure or success?," Journal of Health Economics, Elsevier, vol. 32(5), pages 909-921.
    2. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    3. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    4. repec:imp:wpaper:9224 is not listed on IDEAS
    5. Westert, Gert P. & Lagoe, Ronald J. & Keskimaki, Ilmo & Leyland, Alastair & Murphy, Mark, 2002. "An international study of hospital readmissions and related utilization in Europe and the USA," Health Policy, Elsevier, vol. 61(3), pages 269-278, September.
    6. Rachel Meacock & Tim Doran & Matt Sutton, 2015. "What are the Costs and Benefits of Providing Comprehensive Seven‐day Services for Emergency Hospital Admissions?," Health Economics, John Wiley & Sons, Ltd., vol. 24(8), pages 907-912, August.
    7. Stephen Martin & Andrew Street & Lu Han & John Hutton, 2014. "The impact of hospital financing on the quality of inpatient care in England," Working Papers 105cherp, Centre for Health Economics, University of York.
    8. Afsaneh Bjorvatn, 2013. "Hospital readmission among elderly patients," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(5), pages 809-820, October.
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    Cited by:

    1. Brendan Walsh & Samantha Smith & Maev-Ann Wren & James Eighan & Seán Lyons, 2022. "The impact of inpatient bed capacity on length of stay," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(3), pages 499-510, April.
    2. Yan Meng & Xueyan Zhao & Xibin Zhang & Jiti Gao, 2017. "A panel data analysis of hospital variations in length of stay for hip replacements: Private versus public," Monash Econometrics and Business Statistics Working Papers 20/17, Monash University, Department of Econometrics and Business Statistics.
    3. Ambugo, Eliva Atieno & Hagen, Terje P., 2019. "Effects of introducing a fee for inpatient overstays on the rate of death and readmissions across municipalities in Norway," Social Science & Medicine, Elsevier, vol. 230(C), pages 309-317.
    4. Walsh, Brendan & Wren, Maev-Ann & Smith, Samantha & Lyons, Seán & Eighan, James & Morgenroth, Edgar, 2019. "An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital," Research Series, Economic and Social Research Institute (ESRI), number RS91, June.

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