Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals
We did a retrospective study of 1920 episodes of community-acquired pneumonia (CAP) in 27 community hospitals and analysed inter-hospital variability in length of hospital stay (LOS), mortality and readmission rates. The overall adjusted LOS (mean±S.D.) was 10·0±9·8 days. LOS increased according to...
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| Veröffentlicht in: | Epidemiology and infection 2004-10, Vol.132 (5), p.821-829 |
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| creator | CABRE, M. BOLIVAR, I. PERA, G. PALLARES, R. |
| description | We did a retrospective study of 1920 episodes of community-acquired pneumonia (CAP) in 27 community hospitals and analysed inter-hospital variability in length of hospital stay (LOS), mortality and readmission rates. The overall adjusted LOS (mean±S.D.) was 10·0±9·8 days. LOS increased according to the Pneumonia Severity Index (PSI) risk class: 7·3 days for class I to 11·3 days for class V (P |
| doi_str_mv | 10.1017/S0950268804002651 |
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The overall adjusted LOS (mean±S.D.) was 10·0±9·8 days. LOS increased according to the Pneumonia Severity Index (PSI) risk class: 7·3 days for class I to 11·3 days for class V (P<0·001). In a multiple regression model, LOS increased (P<0·001) according to the hospital (inter-hospital variability), PSI risk class, complications during hospitalization, admission to ICU, need of oxygen and transfer to a nursing home. Hospitals with shorter LOS did not show an increased readmission rate (adjusted OR 1·02, 95% CI 0·51–2·03, P=0·97) and post-discharge mortality (adjusted OR 1·20, 95% CI 0·70–2·05, P=0·51). There are significant inter-hospital variations in LOS in patients with CAP which are related to differences in clinical management. The reduction of these differences will further improve efficiency and quality of care.</description><identifier>ISSN: 0950-2688</identifier><identifier>EISSN: 1469-4409</identifier><identifier>DOI: 10.1017/S0950268804002651</identifier><identifier>PMID: 15473144</identifier><identifier>CODEN: EPINEU</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Aged ; Antibiotics ; Biological and medical sciences ; Community-Acquired Infections - epidemiology ; Community-Acquired Infections - etiology ; Community-Acquired Infections - mortality ; Female ; Fundamental and applied biological sciences. Psychology ; Hospital admissions ; Hospital utilization rate ; Hospitalization ; Hospitals, Community - statistics & numerical data ; Humans ; Intensive care units ; Length of stay ; Length of Stay - statistics & numerical data ; Male ; Medical Records ; Microbiology ; Mortality ; Nursing homes ; Pneumonia ; Pneumonia - epidemiology ; Pneumonia - etiology ; Pneumonia - mortality ; Retrospective Studies ; Risk Factors ; Spain - epidemiology ; Teaching hospitals</subject><ispartof>Epidemiology and infection, 2004-10, Vol.132 (5), p.821-829</ispartof><rights>2004 Cambridge University Press</rights><rights>Copyright 2004 Cambridge University Press</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c594t-6218c7d6173bfd750676404d1d3207ebe1418481015b6ada9b380a9d80bb1fb03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/3865755$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/3865755$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,723,776,780,799,881,27901,27902,53766,53768,57992,58225</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16146177$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15473144$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CABRE, M.</creatorcontrib><creatorcontrib>BOLIVAR, I.</creatorcontrib><creatorcontrib>PERA, G.</creatorcontrib><creatorcontrib>PALLARES, R.</creatorcontrib><creatorcontrib>Pneumonia Study Collaborative Group</creatorcontrib><title>Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals</title><title>Epidemiology and infection</title><addtitle>Epidemiol. Infect</addtitle><description>We did a retrospective study of 1920 episodes of community-acquired pneumonia (CAP) in 27 community hospitals and analysed inter-hospital variability in length of hospital stay (LOS), mortality and readmission rates. The overall adjusted LOS (mean±S.D.) was 10·0±9·8 days. LOS increased according to the Pneumonia Severity Index (PSI) risk class: 7·3 days for class I to 11·3 days for class V (P<0·001). In a multiple regression model, LOS increased (P<0·001) according to the hospital (inter-hospital variability), PSI risk class, complications during hospitalization, admission to ICU, need of oxygen and transfer to a nursing home. Hospitals with shorter LOS did not show an increased readmission rate (adjusted OR 1·02, 95% CI 0·51–2·03, P=0·97) and post-discharge mortality (adjusted OR 1·20, 95% CI 0·70–2·05, P=0·51). There are significant inter-hospital variations in LOS in patients with CAP which are related to differences in clinical management. The reduction of these differences will further improve efficiency and quality of care.</description><subject>Aged</subject><subject>Antibiotics</subject><subject>Biological and medical sciences</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Community-Acquired Infections - etiology</subject><subject>Community-Acquired Infections - mortality</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hospital admissions</subject><subject>Hospital utilization rate</subject><subject>Hospitalization</subject><subject>Hospitals, Community - statistics & numerical data</subject><subject>Humans</subject><subject>Intensive care units</subject><subject>Length of stay</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical Records</subject><subject>Microbiology</subject><subject>Mortality</subject><subject>Nursing homes</subject><subject>Pneumonia</subject><subject>Pneumonia - epidemiology</subject><subject>Pneumonia - etiology</subject><subject>Pneumonia - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Spain - epidemiology</subject><subject>Teaching hospitals</subject><issn>0950-2688</issn><issn>1469-4409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV2L1DAUhoMo7rj6AwSR3uhd9aTNV71YkMEdhQVxVfAupEk6k7FNZpNWnH9vxikziuDVuXif856PF6GnGF5hwPz1Z2goVEwIIJArxffQAhPWlIRAcx8tDnJ50C_Qo5S2ANBUgj9EF5gSXmNCFshfKz2GmArnu36yXju_Lnrr1-OmCF2xCWnnRtUXaVT7zBQ6DMPk3bgvlb6bXLSm2Hk7DcE79aZQmZvMb7DiZ_Zkkx6jB10u9slcL9HX63dflu_Lm4-rD8u3N6WmDRlLVmGhuWGY121nOAXGGQFisKkr4La1mGBBRH4CbZkyqmlrAaoxAtoWdy3Ul-jq6Lub2sEabf0YVS930Q0q7mVQTv6teLeR6_BD5v8AZiIbvJwNYribbBrl4JK2fa-8DVOSjDW0YTXNID6COoaUou1OQzDIQ0ryn5Ryz_M_tzt3zLFk4MUMqKRV30WVg0lnjuWUMeeZe3bktimHeNJrwSinh93Ko-zSaH-eZBW_S8ZrTiVbfZJ0Wa1ub-GbZJmv51vU0EZn1lZuwxR9Tuo_1_wC0qbDqw</recordid><startdate>20041001</startdate><enddate>20041001</enddate><creator>CABRE, M.</creator><creator>BOLIVAR, I.</creator><creator>PERA, G.</creator><creator>PALLARES, R.</creator><general>Cambridge University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20041001</creationdate><title>Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals</title><author>CABRE, M. ; BOLIVAR, I. ; PERA, G. ; PALLARES, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c594t-6218c7d6173bfd750676404d1d3207ebe1418481015b6ada9b380a9d80bb1fb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Antibiotics</topic><topic>Biological and medical sciences</topic><topic>Community-Acquired Infections - epidemiology</topic><topic>Community-Acquired Infections - etiology</topic><topic>Community-Acquired Infections - mortality</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Hospital admissions</topic><topic>Hospital utilization rate</topic><topic>Hospitalization</topic><topic>Hospitals, Community - statistics & numerical data</topic><topic>Humans</topic><topic>Intensive care units</topic><topic>Length of stay</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical Records</topic><topic>Microbiology</topic><topic>Mortality</topic><topic>Nursing homes</topic><topic>Pneumonia</topic><topic>Pneumonia - epidemiology</topic><topic>Pneumonia - etiology</topic><topic>Pneumonia - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Spain - epidemiology</topic><topic>Teaching hospitals</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CABRE, M.</creatorcontrib><creatorcontrib>BOLIVAR, I.</creatorcontrib><creatorcontrib>PERA, G.</creatorcontrib><creatorcontrib>PALLARES, R.</creatorcontrib><creatorcontrib>Pneumonia Study Collaborative Group</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Epidemiology and infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CABRE, M.</au><au>BOLIVAR, I.</au><au>PERA, G.</au><au>PALLARES, R.</au><aucorp>Pneumonia Study Collaborative Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals</atitle><jtitle>Epidemiology and infection</jtitle><addtitle>Epidemiol. Infect</addtitle><date>2004-10-01</date><risdate>2004</risdate><volume>132</volume><issue>5</issue><spage>821</spage><epage>829</epage><pages>821-829</pages><issn>0950-2688</issn><eissn>1469-4409</eissn><coden>EPINEU</coden><abstract>We did a retrospective study of 1920 episodes of community-acquired pneumonia (CAP) in 27 community hospitals and analysed inter-hospital variability in length of hospital stay (LOS), mortality and readmission rates. The overall adjusted LOS (mean±S.D.) was 10·0±9·8 days. LOS increased according to the Pneumonia Severity Index (PSI) risk class: 7·3 days for class I to 11·3 days for class V (P<0·001). In a multiple regression model, LOS increased (P<0·001) according to the hospital (inter-hospital variability), PSI risk class, complications during hospitalization, admission to ICU, need of oxygen and transfer to a nursing home. Hospitals with shorter LOS did not show an increased readmission rate (adjusted OR 1·02, 95% CI 0·51–2·03, P=0·97) and post-discharge mortality (adjusted OR 1·20, 95% CI 0·70–2·05, P=0·51). There are significant inter-hospital variations in LOS in patients with CAP which are related to differences in clinical management. The reduction of these differences will further improve efficiency and quality of care.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>15473144</pmid><doi>10.1017/S0950268804002651</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antibiotics Biological and medical sciences Community-Acquired Infections - epidemiology Community-Acquired Infections - etiology Community-Acquired Infections - mortality Female Fundamental and applied biological sciences. Psychology Hospital admissions Hospital utilization rate Hospitalization Hospitals, Community - statistics & numerical data Humans Intensive care units Length of stay Length of Stay - statistics & numerical data Male Medical Records Microbiology Mortality Nursing homes Pneumonia Pneumonia - epidemiology Pneumonia - etiology Pneumonia - mortality Retrospective Studies Risk Factors Spain - epidemiology Teaching hospitals |
| title | Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals |
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