Hartz A J, Bade P F, Sigmann P, Guse C, Epple P, Goldberg K C
Medical College of Wisconsin, Milwaukee 53226, USA.
Int J Qual Health Care. 1996 Feb;8(1):3-11. doi: 10.1093/intqhc/8.1.3.
This study compared three methods to screen charts of pneumonia patients for excess days.
A derivation data set was used to statistically derive a severity measure to predict length of stay for pneumonia patients and to refine a clinical algorithm for identifying excess stay. A validation data set was used to compare three computerized methods to screen for unnecessary hospital days: (1) an observed length of stay greater than a target value; (2) an observed stay greater than predicted for the specific patient; and (3) an algorithm that tested whether there were clinical justifications for the entire hospital stay.
The sensitivity and specificity for detecting excess stay for the three methods were (1) 0.48 and 0.85 for the observed stay greater than the target value; (2) 0.56 and 0.73 for observed stay greater than predicted; and (3) 0.83 and 0.85 for the algorithm.
These results suggest that computerized clinical algorithms may provide a useful method to detect unnecessary hospital stay.
