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Dysfunctional Systems Prolong Hospital Stay After Trauma

Dysfunctional Systems Prolong Hospital Stay After Trauma

In published studies, excessively prolonged hospitalization has been linked with higher clinical risks and increased costs. Some studies have suggested that increases in clinical risks—such as nosocomial infections, DVT, drug reactions, medication errors, and other adverse events—are directly related to the length of time spent in the hospital. “Hospital length of stay (LOS) has been identified as one of the major drivers of resource consumption,” says George C. Velmahos, MD, PhD, MSEd. “Hospital costs can increase because beds and human personnel are occupied by patients who have excessively prolonged hospital-izations.” He adds that there are also significant societal costs that result from these patients due to lost productivity. Exploring Reasons In JAMA Surgery, Dr. Velmahos and colleagues had a study published that identified trauma patients with excessively prolonged hospitalizations and explored the reasons for these occurrences. “This information can be beneficial to policy makers who are striving to understand the medical system and associated costs of long hospitalizations,” Dr. Velmahos says. He notes that the burden of injury, significant comorbidities, and postoperative complications are likely to be causes of excessively prolonged hospitalization, but other factors may also be at play. For the study, investigators reviewed a trauma registry, billing databases, and medical records of trauma admissions at a level I academic trauma center. Patients with excessively prolonged hospitalizations were older, more likely to have blunt trauma, and more likely to be self-payers or covered by Medicare or Medicaid. They were also more likely to be discharged to post–acute care facilities than home and had higher hospitalization costs. “Only 5% of patients in our study had excessively prolonged hospitalizations, but...
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