Do severity measures explain differences in length of hospital stay?
” HSR: Health Services Research 31(4), pp. 365-385. The researchers used 14 severity-of-illness measures to evaluate hospitals expected versus observed length of stay for elderly hip fracture patients. Hospitals are reimbursed a set amount by Medicare based on a patients diagnosis, called the diagnosis-related group (DRG). Hospitals have argued that they should be reimbursed more for more severely ill patients in the same DRG. In this study, the researchers used different severity measures to evaluate whether the measures had any impact on one cost factor, hospital length of stay (LOS). They used each measure to evaluate expected LOS for 5,664 elderly patients admitted to 80 hospitals nationwide in 1992 for surgical repair of a hip fracture. They found that the patients had a mean LOS of 12 days. Observed average LOS for hospitals ranged from 8 to 24 days. Although the 14 severity measures showed excellent agreement in ranking hospitals based on z-scores (observed average LOS minus exp
