Benchmarking and reducing length of stay in Dutch hospitals

Abstract

Background: To assess the development of and variation in lengths of stay in Dutch hospitals and to determine the potential reduction in hospital days if all Dutch hospitals would have an average length of stay equal to that of benchmark hospitals.

Economic impact of hospitalisations among patients in the last year of life: An observational study

“…16 If the LOS for all 483 patients in this study was reduced by 14% (5 days), this would result in an estimated saving in hospital costs of £406,324.This compares with the hospital cost saving of £212,397 for preventing the 35 potentially avoidable index admissions.…”

Disinvestment for re-allocation: A process to identify priorities in healthcare

“…Likewise, for the ALOS indicator the consensus exercise suggested that a conservative approach keeping the benchmark and the minimum effort equivalent because of limits on case mix adjustment around ALOS. This is a conservative approach given that different authors have used more aggressive approaches [21,28,29].…”

Fifty ways to reduce length of stay: An inventory of how hospital staff would reduce the length of stay in their hospital

“…(2) Stipulate conditions at which discharge at weekends is possible (2) Prevent admissions that result from a hectic environment in the outpatient department (5) Do not let the patients stay until the Centre specific patient groups (2) results are received (1) Do not occupy clinical beds with day-care patients (1) Develop plan for expediting treatment. Do not wait until making 'rounds' (2) Organise meetings in order to discuss patients in a way that does not create treatment waiting times (1) ( (77) Make use of specialised nurses to prevent, or expedite, clinical care (9) Reduce waiting times for diagnostic tests or interventions: inside one's own hospital (16) Develop a team of effective discharge planners (6) Set up an observatory for questionable admissions (6) Improve cooperation between physicians: inside their own hospital (11) Arrange effective aftercare in the outpatient department (5) Admit patients through the right specialty (4) Optimise the number of beds for each ward and make arrangements about 'own beds' so that these beds will not be occupied by other specialties) (6) Prevent admissions that are admitted to get round a waiting list for ambulatory patients (3) Shorten waiting times for the operating theatre (3) Optimise cooperation with paramedics Optimise the admission office (2) and stimulate early rehabilitation (2) …”

“…If all Dutch hospitals were as efficient as the benchmark hospitals, then a total gain of at least 1.8 million hospital days, or 14% of all hospital days, would have been attainable for 2006 [4]. The inter-hospital variation in length of stay is still substantial -even after standardising for case-mix -not only in the Netherlands, but also in other countries [5][6][7][8][9][10][11].…”