Background Rising health care costs have prompted careful review of comparative hospital resource use.
Length of stay after bypass surgery has received particular attention.
However, many providers assert that these variations are caused by differences in the clinical mix of patients treated.
Our gools were to identify the major clinical predictors of postoperative length of stay (PLOS) after coronary artery bypass graft surgery (CABG), document variations in PLOS among 28 hospitals, and assess the degree to which patient characteristics account for hospital variations in PLOS.
Methods Detailed clinical data on 3605 Medicare patients undergoing CABG in 28 Alabama and Iowa hospitals were analyzed by stepwise linear regression to identify significant clinical predictors of PLOS.
Analysis of variance was used to compare hospitals'PLOS while controlling for significant patient risk factors.
Results The mean age was 72.1 years, 34.7% were female, and the inhospital mortality rate was 5.6%. The median and mean PLOS were 8 and 11.1 days, respectively.
Significant predictors of longer PLOS included increasing age, female sex, history of chronic obstructive pulmonary disease, cerebrovascular disease, or mitral valve disease, elevated admission blood urea nitrogen, and preoperative placement of an intraaortic bolloon pump.
Hospitals varied significantly (P=0001) in their unadjusted PLOS. (...)
Mots-clés Pascal : Dérivation, Aortocoronaire, Homme, Hospitalisation, Temps séjour, Economie santé, Chirurgie
Mots-clés Pascal anglais : Bypass, Aortocoronary, Human, Hospitalization, Residence time, Health economy, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0416598
Code Inist : 002B25E. Création : 22/03/2000.