Variation in hospital length of stay for acute myocardial infarction in Ontario, Canada, during fiscal 1990
Subtitle: a population-based analysis
By: E. Chen, C. D. Naylor.
Contributors: Chen, E.; Naylor, C. D.; Institute for Clinical Evaluative Sciences in Ontario.
Series: ICES working paper series -- no. 3
Publisher: Institute for Clinical Evaluative Sciences in Ontario
Published: 1993
Place of publication: Ontario
Language: eng
Number of pages: 28
Subjects: Length of Stay -- statistics & numerical data; Myocardial Infarction; Health Care Rationing; Health Policy; Myocardial Infarction -- mortality; Myocardial Infarction -- therapy; Regional Health Planning; Retrospective Studies; Humans; Ontario
Description: OBJECTIVES.  Examine variation in length of stay for acute myocardial infarction [AMI] across hospitals in a universal hospital care system. DESIGN.  Population-based case series analysis, using administrative data.  SETTING.  187 acute general hospitals in Ontario, Canada. PARTICIPANTS.  11,411 records of patients with primary discharge diagnosis of AMI from April 1, 1990 to March 31, 1991, excluding all inter-hospital transfers, in-hospital deaths and patients with severe comorbid conditions.  MAIN OUTCOME MEASURES.  Length of stay in days. RESULTS.  The mean length of stay was 9.9 days with standard deviation of 3.82.  Available patient and hospital characteristics explained only 11% of the individual variation in length of stay.  Inter-institutional variation remained highly significant after controlling for patients' characteristics within the 87 hospitals admitting more that 50 cases per annum; these included 84% of the eligible provincial admissions.  The grand mean length of stay for 87 hospitals was 10 days, but hospital-specific means ranged from 6.6 to 12.9 days.  Stepwise multiple linear regression analyses showed that lower caseload was associated with an increased length of hospitalization.  CONCLUSIONS.  Despite Ontario's uniform system of hospital funding and medical insurance, a large amount of unexplained variation in length of stay exists for patients hospitalized with acute myocardial infarction, affecting thousands of bed-days per annum.
Notes: March 1993.

Includes bibliographical references. (23 ref.)