Analyzing Hospital High Length of Stay Outliers in Turkey

Abstract

Purpose: The aim of this study is to examine length of stay (LOS) outliers by analyzing hospital administrative database. Material and Methods: The Turkish Ministry of Health DRG grouper database was utilized to obtain hospital administrative data on discharges for 15 training and research hospitals in 2012. For each diagnosis-related group (DRG), the geometric mean plus two standard deviations were calculated to identify outliers. Analyses were conducted using descriptive statistics and logistic regression using generalized estimating equations (GEE). Results: High LOS outliers found to be 4.4 % of the cases, they were responsible for 24.50 percent of all discharge days. Alcohol, drug use disorders, burns, and diseases of the ear, nose, mouth, and throat were the factors that had the greatest impact on high LOS outliers, according to the multivariate model. Conclusion: A quarter of all inpatient days are made up of LOS outliers. Burns, neonate cases, and alcohol/drug use issues should all be carefully evaluated. In order to improve clinical quality and effectively manage hospital resources, hospital administrators and health policy makers should take length of stay outliers into consideration.

Keywords

• Case mix
• Diagnosis-Related Groups
• DRG Outliers
• Hospital Financial Management
• Length of Stay

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