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American Medicine

How much time is right for a hospital stay?

No one wants to be in a hospital, ever! But for many illnesses or accidents, hospitalization is needed. Lengths of hospital stays used to be very long, 7-14 days. But with the increased costs of health care in America, insurance companies, hospitals and physicians have taken steps to shorten the length of hospitalizations.

In a recent article, Dr. P. Kaoboli and coauthors studied how long patients were staying in VA hospitals (Annals of Internal Medicine, volume 157, page 157, December 2012). They found that since 1997, average length of stay for all conditions reduced 27% down to only 3.98 days. That increased efficiency of taking care of patients probably resulted from better and more rapid testing and therapy and shifting some care to home care agencies after discharge. But patients benefitted by reducing the chances of getting complications in the hospital, such as infections, blood clots, falls, or medication errors.

But surprisingly, hospitals that had average hospital stays that were shorter than the national average expected for the illness of a patient had a higher readmission rate! For each day below the expected, readmission rates increased by 6%. But for each day longer than expected, readmission rates were increased by 3%. This means that your length of stay should be “not too long” and “not too short” but just right. It sounds like the story of Goldilocks, doesn’t it? But it makes sense. You should get the right amount of care and not too much or too little.

Here are my tips:

• When you go to the hospital, ask the nurses what is the expected length of stay for your condition. If they do not know, ask to speak to the discharge planner.
• Ask the discharge planner early in your hospital stay what help you will have after discharge. Specifically ask about home care nursing.
• Be certain your doctor advises you how your care will be transitioned back to the physician’s office.
• Make certain that your medications are reconciled before discharge, so you know which medicines you should be taking and which drugs you were taking before hospitalization should be stopped or continued or changed in dose, and which new medicines will be needed.
• Ask to talk to the hospital pharmacist for advice on medicine, side effects, and how to reduce costs.

For more advice on hospitals see Chapter 18 Getting Better Care in the Hospital in my book Surviving American Medicine available at Amazon.com, Barnesandnoble.com and iUniverse.com.