IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0207203.html
   My bibliography  Save this article

Risk factors associated with prolonged hospital length-of-stay: 18-year retrospective study of hospitalizations in a tertiary healthcare center in Mexico

Author

Listed:
  • Braulio A Marfil-Garza
  • Pablo F Belaunzarán-Zamudio
  • Alfonso Gulias-Herrero
  • Antonio Camiro Zuñiga
  • Yanink Caro-Vega
  • David Kershenobich-Stalnikowitz
  • José Sifuentes-Osornio

Abstract

Background: Hospital length-of-Stay has been traditionally used as a surrogate to evaluate healthcare efficiency, as well as hospital resource utilization. Prolonged Length-of-stay (PLOS) is associated with increased mortality and other poor outcomes. Additionally, these patients represent a significant economic problem on public health systems and their families. We sought to describe and compare characteristics of patients with Normal hospital Length-of-Stay (NLOS) and PLOS to identify sociodemographic and disease-specific factors associated with PLOS in a tertiary care institution that attends adults with complicated diseases from all over Mexico. Materials and methods: We conducted a retrospective analysis of hospital discharges from January 2000-December 2017 using institutional databases of medical records. We compared NLOS and PLOS using descriptive and inferential statistics. PLOS were defined as those above the 95th percentile of length of hospitalization. Results: We analyzed 85,904 hospitalizations (1,069,875 bed-days), of which 4,427 (5.1%) were PLOS (247,428 bed-days, 23.1% of total bed-days). Hematological neoplasms were the most common discharge diagnosis and surgery of the small bowel was the most common type of surgery. Younger age, male gender, a lower physician-to-patient ratio, emergency and weekend admissions, surgery, the number of comorbidities, residence outside Mexico City and lower socioeconomic status were associated with PLOS. Bone marrow transplant (OR 18.39 [95% CI 12.50–27.05, p

Suggested Citation

  • Braulio A Marfil-Garza & Pablo F Belaunzarán-Zamudio & Alfonso Gulias-Herrero & Antonio Camiro Zuñiga & Yanink Caro-Vega & David Kershenobich-Stalnikowitz & José Sifuentes-Osornio, 2018. "Risk factors associated with prolonged hospital length-of-stay: 18-year retrospective study of hospitalizations in a tertiary healthcare center in Mexico," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-14, November.
    • Handle: RePEc:plo:pone00:0207203
    DOI: 10.1371/journal.pone.0207203
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207203
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0207203&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0207203?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    2. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
    3. Magali Pirson & Dimitri Martins & Terri Jackson & Michèle Dramaix & Pol Leclercq, 2006. "Prospective casemix-based funding, analysis and financial impact of cost outliers in all-patient refined diagnosis related groups in three Belgian general hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(1), pages 55-65, March.
    4. Hyunyoung Baek & Minsu Cho & Seok Kim & Hee Hwang & Minseok Song & Sooyoung Yoo, 2018. "Analysis of length of hospital stay using electronic health records: A statistical and data mining approach," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-16, April.
    5. Claudia Fischer & Hester F Lingsma & Perla J Marang-van de Mheen & Dionne S Kringos & Niek S Klazinga & Ewout W Steyerberg, 2014. "Is the Readmission Rate a Valid Quality Indicator? A Review of the Evidence," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-9, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Małgorzata Cygańska & Magdalena Kludacz-Alessandri & Chris Pyke, 2023. "Healthcare Costs and Health Status: Insights from the SHARE Survey," IJERPH, MDPI, vol. 20(2), pages 1-14, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. de Menil, Victoria & Knapp, Martin & McDaid, David & Njenga, Frank Gitau, 2014. "Service use, charge, and access to mental healthcare in a private Kenyan inpatient setting: the effects of insurance," LSE Research Online Documents on Economics 56444, London School of Economics and Political Science, LSE Library.
    2. Md Mahfuzur Rahman & Cherri Zhang & Khin Thet Swe & Md Shafiur Rahman & Md Rashedul Islam & Md Kamrujjaman & Papia Sultana & Md Zakiul Hassan & Md Shahinul Alam & Md Mizanur Rahman, 2020. "Disease-specific out-of-pocket healthcare expenditure in urban Bangladesh: A Bayesian analysis," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-11, January.
    3. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    4. Xiaowei Yang & Jianmin Gao & Zhongliang Zhou & Jue Yan & Sha Lai & Yongjian Xu & Gang Chen, 2016. "Assessing the Effects of the New Cooperative Medical Scheme on Alleviating the Health Payment-Induced Poverty in Shaanxi Province, China," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-12, July.
    5. Kim, Chang-O & Joung, Won Oh, 2014. "Effect of the Crisis Assistance Program on poverty transition for seriously ill people in South Korea: A quasi-experimental study," Social Science & Medicine, Elsevier, vol. 101(C), pages 28-35.
    6. Pavithra Harshani Warnakulasooriya & Kaushalya Kasturiaratchi, 2022. "The household economic cost of caregivers: children with congenital heart diseases attending to Pediatric Hospital, Sri Lanka," South Asia Economic Journal, Institute of Policy Studies of Sri Lanka, vol. 23(1), pages 52-60, March.
    7. Rebecca L. Thornton & Laurel E. Hatt & Erica M. Field & Mursaleena Islam & Freddy Solís Diaz & Martha Azucena González, 2010. "Social security health insurance for the informal sector in Nicaragua: a randomized evaluation," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 181-206, September.
    8. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    9. Patrick Sakdapolrak & Thomas Seyler & Christina Ergler, 2013. "Burden of direct and indirect costs of illness: Empirical findings from slum settlements in Chennai, South India," Progress in Development Studies, , vol. 13(2), pages 135-151, April.
    10. Ranveig Marie Boge & Arvid Steinar Haugen & Roy Miodini Nilsen & Frøydis Bruvik & Stig Harthug, 2019. "Discharge care quality in hospitalised elderly patients: Extended validation of the Discharge Care Experiences Survey," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-15, September.
    11. Nguyen, Kim Thuy & Hai Khuat, Oanh Thi & Ma, Shuangge & Pham, Duc Cuong & Hong Khuat, Giang Thi & Ruger, Jennifer Prah, 2012. "Coping with health care expenses among poor households: Evidence from a rural commune in Vietnam," Social Science & Medicine, Elsevier, vol. 74(5), pages 724-733.
    12. Ebaidalla Mahjoub Ebaidalla & Mohammed Elhaj Mustafa Ali, 2018. "Chronic Illness and Labor Market Participation in Arab Countries: Evidence from Egypt and Tunisia," Working Papers 1229, Economic Research Forum, revised 10 Oct 2018.
    13. Nila Larisse Silva de Albuquerque & Thelma Leite de Araujo & Marcos Venicios de Oliveira Lopes & Thereza Maria Magalhães Moreira, 2020. "Hierarchical analysis of factors associated with hospital readmissions for coronary heart disease: A case–control study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2329-2337, July.
    14. Omar Galárraga & Sandra Sosa-Rubí & Aarón Salinas-Rodríguez & Sergio Sesma-Vázquez, 2010. "Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 437-447, October.
    15. Lia Gentil & Guy Grenier & Helen-Maria Vasiliadis & Marie-Josée Fleury, 2022. "Predictors of Length of Hospitalization and Impact on Early Readmission for Mental Disorders," IJERPH, MDPI, vol. 19(22), pages 1-19, November.
    16. Anja Sautmann & Samuel Brown & Mark Dean, 2016. "Subsidies, Information, and the Timing of Childrenís Health Care in Mali," Working Papers 2016-2, Brown University, Department of Economics.
    17. Kuluski, Kerry & Cadel, Lauren & Marcinow, Michelle & Sandercock, Jane & Guilcher, Sara JT, 2022. "Expanding our understanding of factors impacting delayed hospital discharge: Insights from patients, caregivers, providers and organizational leaders in Ontario, Canada," Health Policy, Elsevier, vol. 126(4), pages 310-317.
    18. Samuel D. Towne & Xiaojun Liu & Rui Li & Matthew Lee Smith & Jay E. Maddock & Anran Tan & Samah Hayek & Shira Zelber-Sagi & Xiaoqing Jiang & Haotian Ruan & Zhaokang Yuan, 2021. "Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China," IJERPH, MDPI, vol. 18(11), pages 1-11, June.
    19. Meng, Zhaolin & Hui, Wen & Cai, Yuanyi & Liu, Jiazhou & Wu, Huazhang, 2020. "The effects of DRGs-based payment compared with cost-based payment on inpatient healthcare utilization: A systematic review and meta-analysis," Health Policy, Elsevier, vol. 124(4), pages 359-367.
    20. Dr Sukhan Jackson & Xiaoyun Sun1 & Gordon Carmichael & Adrian C. Sleigh1., 2007. "Catastrophic Payment and Health Protection in Rural China - Impact of New Cooperative Medical Scheme in Shandong Province," Discussion Papers Series 344, School of Economics, University of Queensland, Australia.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0207203. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.