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However, stays that are too short may reduce the quality of care and patients who are sent home The Authority bases its performance reports before they are ready may experience poorer on the 48 indicators agreed by the Council of outcomes.4 Some evidence suggests that shorter Australian Governments (COAG). In this report, stays can lead to higher readmission rates, the Authority has focused on the indicator Relative leading to additional costs and more time Stay Index for multi-day stay patients.
This report provides information on length of stay among patients who spent at least one night in associated with higher hospital infection rates and a public hospital for one of 16 selected conditions other adverse events.6 But as shown in this report, and procedures. It compares average length longer stays are often due to complications, which of stay in Australia’s 125 largest public hospitals can more than double the average length of stay. against their peers, based on hospital size Complications can be caused by a number of and location. This type of information is now factors, including some that are intrinsic to the available for more than 600 hospitals at patient and their condition, meaning they do not reflect on the quality or efficiency of the hospital care they receive. This information is intended to help clinicians, health managers, administrators and the public As a result, the Authority makes no determination understand how length of stay differs across the in this report that any particular hospital is country. The efficiency of Australia’s health system performing well or poorly in relation to length of would increase if steps were taken to enable more stay. It intends this new information to be used people to safely return home from hospital as by health professionals to identify the impact of enabling more people to safely return home from This report examines an indicator that offers some The most appropriate way to compare a hospital’s insight into the efficiency of hospitals and local average length of stay and identify potential health systems: the average length of stay among opportunities for improvement is to focus on patients who spent at least one night in hospital. specific conditions and performance relative to similar hospitals. A shorter length of stay is typical y considered more efficient from a hospital’s perspective, making beds available more quickly to provide care for more patients, as well as reducing the cost per patient.3 Hospital Performance: Length of stay in public hospitals in 2011–12 This report presents average length of stay for 16 selected conditions and procedures (See Box 1, Direct comparisons between hospitals are not page 4). These conditions and procedures provide necessarily fair because hospitals differ in the a cross-section of the three major acute care services they provide and the types of patients to activity categories: childbirth, medical conditions and surgical procedures. These 16 conditions or procedures are some of the most frequently seen The Authority has taken a number of steps to by health professionals in public hospitals.
ensure comparisons are between similar patients as well as similar hospitals.
The average length of stay is the total number of days spent in a hospital divided by the number of To enable fairer comparisons, the Authority has stays, and only includes the stays of patients who al ocated public hospitals to peer groups based on size and rurality. This report presents comparison figures for the four largest peer groups: The fol owing patient stays were excluded from the analyses to improve the comparability of • Rapid patient transfers to other hospitals Specialist women’s and children’s hospitals are treated separately for this report. Women’s hospitals are presented as part of the major Data used by the Authority to calculate the metropolitan group for childbirth, hysterectomy, measures in this report were provided by the and gynaecological reconstructive procedures states and territories to the Admitted Patient Care and contribute to the peer group average. National Minimum Data Set 2011–12. This data provides information about the hospital stays of all Children’s hospitals have high numbers of stays public and private patients in Australia.
for appendix removal, cellulitis, and kidney and urinary tract infections without complications. For For more detail on how length of stay is these conditions, they form their own peer group determined, see Hospital Performance: Length (excluding women’s hospitals) and comparisons of stay in public hospitals in 2011–12, Technical are presented on the MyHospitals website.
Hospital Performance: Length of stay in public hospitals in 2011–12 Another way this report facilitates fair comparisons is in presenting the length of stay of patients for a single condition or procedure at a time. Patients with complications and other health conditions that make their cases more complex are considered separately to patients without these factors. In addition, the analysis excluded same-day patients, patients who were transferred to other hospitals, or who died during their stay, increasing the similarity of the patients in the analysis. Furthermore, many of the conditions or procedures (including childbirth, cellulitis, lung disease and heart failure) tend to affect people with similar characteristics, which can variously include age, gender, lifestyle factors and pre-existing health conditions. Taken together, this removes a number of factors that may otherwise have partial y explained the variations observed in lengths of stay.
Improving comparisonsIn preparing this report, the Authority investigated the feasibility of producing a measure of each hospital’s overall length of stay, the relative stay index. This type of index, however, would not identify clinical areas to target improvement. Therefore, this report focuses on clinical conditions that are common and represent major areas of medical and surgical care. The Authority undertook to risk-adjust and age-standardise the length of stay data to improve comparability between hospitals. The Authority concluded that the low number of stays for some conditions and procedures in some hospitals made this approach technical y unreasonable. Hospital Performance: Length of stay in public hospitals in 2011–12 Box 1: The 16 selected conditions and procedures The Authority selected the fol owing 16 conditions and procedures in conjunction with technical and clinical stakeholder committees: • Gynaecological reconstructive procedures • Kidney and urinary tract infections without • Kidney and urinary tract infections with For details on how these were selected, see Hospital Performance: Length of stay in public hospitals in 2011–12, Technical Supplement. Hospital Performance: Length of stay in public hospitals in 2011–12

Source: http://www.myhospitals.gov.au/Content/Reports/average-length-of-stay/2013-11/pdf/HospitalPerformance_LOS_2011-12_Introduction.pdf