Efficiency

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Efficiency is key when it comes to length of hospital stays

Childrens asthma patients hospitalIt's simple: when a child is hospitalized, he or she should stay in the hospital for the appropriate length of time: long enough to treat the condition, but not longer than necessary.

  • Too short a stay may mean that the child is not ready for discharge.

  • Too long of a stay disrupts the child’s life unnecessarily and may expose the child to unnecessary risks of hospitalization.

By being efficient, hospitals avoid the waste of time, money and resources that contribute to the high cost of health care in the U.S. 

How do hospitals determine whether care is provided efficiently?

One measure of whether care is provided efficiently is the length of stay, or the number of days children spend in the hospital. Another way to determine whether care is provided efficiently is to track the readmission rate, or how often children need to be readmitted to the hospital within 72 hours of discharge.

In summary, efficient care depends on:

  • Making sure that a child stays in the hospital for the right length of time, but no longer than necessary.
     
  • Making sure that a child does not have to be readmitted to the hospital within a short period of time, which indicates that he or she may have been discharged too soon.

How does Boston Children's Hospital track these measures?

In order to focus on the right length of stay, we always think of these two measures together when reviewing quality of care.

Boston Children’s Hospital  is part of a group of children’s hospitals throughout the country, which share their length of stay and readmission data.  Through a central database, called the Pediatric Health Information System (PHIS), we can evaluate our data and compare ourselves with other children’s hospitals.

Children who are sicker may need to stay in the hospital longer and may be readmitted to the hospital more frequently than children who are less sick.  Because Children’s Hospital Boston cares for many very sick children from throughout New England, it is important that we consider the level of illness of each child. 

To do that, we use a statistical model that tries to adjust for how sick each child is.  This adjustment helps us to better interpret our length of stay and hospital readmission data.  We call this “risk adjustment.”
 

How does Boston Children's compare to other hospitals?

Our median length of stay for all children admitted to the hospital for any reason during the first quarter of 2012 was 2.5 days, which is lower than the median length of stay at our comparable children’s hospitals group (2.7 days).

A median length of stay means that half of patients were in the hospital for more than 2.5 days, and half of patients were in the hospital for less than 2.5 days.

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