Extending hospital stay by one day can reduce readmissions

Keeping patients in the hospital one day longer can significantly reduce readmissions, save costs, and save patients’ lives, according to a new study by the Columbia Business School.

Researchers Ann Bartel and Carri Chan analyzed more than 6.6 million medical records from the Centers for Medicare and Medicaid Services (CMS) from patients 65 years and older who had in-hospital visits from 2008 to 2011.

The research compared the benefits of a one-day extension on reduced readmission, death rates and costs to those of outpatient care.

The authors note that the study results come at a time when CMS is levying financial penalties against hospitals for excessive readmissions under the Hospital Readmissions Reduction Program (HRRP).

READ: Readmissions decline in wake of CMS program

“Given the stiff penalties imposed under the Affordable Care Act, hospitals are implementing a variety of approaches to aggressively reduce readmission rates, most commonly involving outpatient care,” said Bartel, professor of finance and economics at Columbia Business School. “While some types of outpatient interventions can be effective, our study shows that hospitals should consider keeping some of their patients in the hospital longer to better control patient care, reduce readmissions and ensure fewer deaths.”

The study, Should Hospitals Keep Their Patients Longer? The Role of Inpatient and Outpatient Care in Reducing Readmissions, found that one extra day in the hospital can:

•Reduce mortality risk by 22 percent for patients treated for pneumonia
•Reduce mortality risk by 7 percent for heart-attack patients
•Result in five-to-six times more lives being saved when compared with outpatient care
•Decrease readmission rates by 7 percent for severe heart-failure patients 

The study also found a lower cost associated with keeping patients one extra day versus follow-up outpatient care.

“Currently, about one in every five Medicare patients is readmitted to the hospital,” said Chan, associate professor of decision, risk, and operations at Columbia Business School. “Our findings show that one extra day in the hospital could reduce these readmission rates, ensure healthier patients, and save money.”