Summary
Objectives:
To identify factors associated with hospital length of stay (LOS) and to model variations
in LOS within Diagnosis Related Groups (DRGs).
Methods:
A proportional hazards frailty modelling approach is proposed that accounts for patient
transfers and the inherent correlation of patients clustered within hospitals. The
investigation is based on patient discharge data extracted for a group of obstetrical
DRGs.
Results:
Application of the frailty approach has highlighted several significant factors after
adjustment for patient casemix and random hospital effects. In particular, patients
admitted for childbirth with private medical insurance coverage have higher risk of
prolonged hospitalization compared to public patients.
Conclusions:
The determination of pertinent factors provides important information to hospital
management and clinicians in assessing the risk of prolonged hospitalization. The
analysis also enables the comparison of inter-hospital variations across adjacent
DRGs.
Keywords
Diagnosis-Related Groups - Length of Stay - Proportional Hazards Models - Survival
Analysis
