Declining length of stay for patients hospitalized with AMI: impact on mortality and readmissions
Department of Medicine, Division of Cardiovascular Medicine; Department of Quantitative Health Sciences; Meyers Primary Care Institute
Medical Subject Headings
Acute Disease; Age Factors; Aged; Aged, 80 and over; Confidence Intervals; Female; Humans; Length of Stay; Logistic Models; Male; Middle Aged; Myocardial Infarction; New England; Odds Ratio; Patient Readmission; Sex Factors
Biostatistics | Cardiovascular Diseases | Epidemiology | Health Services Research
BACKGROUND: Length of hospital stay after acute myocardial infarction decreased significantly in the 1980s and 1990s. Whether length of stay has continued to decrease during the 2000s, and the impact of decreasing length of stay on rehospitalization and mortality, is unclear. We describe decade-long (1995-2005) trends in length of stay after acute myocardial infarction, and examine whether declining length of stay has impacted early rehospitalization and postdischarge mortality in a population-based sample of hospitalized patients.
METHODS: The study sample consisted of 4184 patients hospitalized with acute myocardial infarction in a central New England metropolitan area during 6 annual periods (1995, 1997, 1999, 2001, 2003, 2005).
RESULTS: The average age of the study sample was 71 years, and 54% were men. The average length of stay decreased by nearly one third over the 10-year study period, from 7.2 days in 1995 to 5.0 days in 2005 (P <.001). Younger patients (<65 years), men, and patients with an uncomplicated hospital stay had significantly shorter lengths of stay than respective comparison groups. Lengths of stay shorter than the median were not associated with significantly higher odds of hospital readmission at 7 or 30 days postdischarge, or with mortality in the year after discharge. In contrast, longer lengths of stay were associated with significantly higher odds of short-term mortality. These findings did not vary by year under study.
CONCLUSIONS: Length of stay in patients hospitalized for acute myocardial infarction decreased significantly between 1995 and 2005. Declining length of stay is not associated with an increased risk for early readmission or all-cause mortality.
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Citation: Am J Med. 2010 Nov;123(11):1007-15. Link to article on publisher's site
Saczynski, Jane S.; Lessard, Darleen M.; Spencer, Frederick A.; Gurwitz, Jerry H.; Gore, Joel M.; Yarzebski, Jorge L.; and Goldberg, Robert J., "Declining length of stay for patients hospitalized with AMI: impact on mortality and readmissions" (2010). Quantitative Health Sciences Publications and Presentations. 960.