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Length of hospital stay for cerebrovascular disease in the United States: Professional Activity Study, 1963-1991.

Abstract：

OBJECTIVE:To assess the temporal and spatial variation in length of hospital stay for cerebrovascular disease in the United States over three decades. DESIGN:Age-, region-, and stroke type-specific length-of-hospital-stay data for nearly 4 million patients admitted with cerebrovascular disease were obtained for the Professional Activity Study of the Commission on Professional and Hospital Activities for the period 1963-1991. MAIN OUTCOME MEASURE:Weighted averages and standard errors of length of stay were calculated for aggregate diagnosis groups within the category of cerebrovascular disease. Averages were age-adjusted by the direct method. RESULTS:Average length of hospital stay declined from a peak of 18 days in 1967 to 8 days in 1991. The decline accelerated sharply from 1982 to 1986 coincident with implementation of the Medicare prospective payment system. Similar declines were observed within each age group, each cerebrovascular disease diagnosis group, and each census region. There were marked and persistent differences in average length of stay between regions, with longer stays in the Northeast and shorter stays in the West. The large interregional variation was not explained by differences in age or cerebrovascular disease diagnoses. CONCLUSIONS:Implementation of the Medicare prospective payment system produced a marked decline in length of hospital stay for cerebrovascular disease, which was superimposed on a preexisting, but slower, decline. Much of the marked persistent interregional variation probably results from persistent widespread variation in patient management.

journal_name

J Neurol Sci

journal_title

Journal of the neurological sciences

authors

Lanska DJ

doi

10.1016/0022-510x(94)90075-2

subject

Has Abstract

pub_date

1994-12-20 00:00:00

pages

214-20

issue

2

eissn

0022-510X

issn

1878-5883

pii

0022-510X(94)90075-2

journal_volume

127

pub_type

杂志文章

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