New study findings suggest that patients treated at low volume hospitals have shorter length-of-stay (LOS) and may be discharged earlier than from high volume hospitals. Emergency abdominal surgery (EAS) refers to high risk intra-abdominal surgical procedures associated with increased mortality risk and long length of hospital stay. The variation between hospital volume and hospital LOS of patients undergoing EAS is poorly understood. Researchers from Royal College of Surgeons in Ireland (RCSI) sought to explore this relationship across public hospitals in Ireland. Data for all adult episode discharges from public Irish hospitals in 2014-2017 were obtained from National Quality Assurance Improvement System (NQAIS) Clinical with EAS identified by primary procedure codes. A total of 8120 hospital episodes across 24 public hospitals providing EAS services were analysed. The study found high volume hospitals had a significantly longer adjusted LOS (24.7 days) relative to low and medium volume hospitals (18.2 and 18.6 days). This surprising finding suggests that concentration of services to larger clinical departments may not necessarily reduce LOS and improve the efficiency of resource utilisation and service delivery.
- Variation in Hospital Length of Stay Based on Hospital Volume: A Retrospective Cohort Study of Emergency Abdominal Surgery in Ireland, Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, 17 Dec 2019