Average Length of Stay, Average Preventable Readmission Rates, and Average Total Cost of Care: Is there a Relationship?

Abstract

Average Length of Stay (ALOS), Average Preventable Readmission Rates (APRRs), and Average Total Cost of Care (ATCc) were examined to see if any relationship exists among the variables. Secondary data from the Texas Hospital data collection database was used for the study. Out of 379 acute care hospitals in Texas, 65 hospitals were selected for analysis using a G*Power analysis. Demographic analysis, Spearman’s Rank correlation, and Regression Analyses were conducted to explore the relationship. The results of the Spearman’s Rho correlation showed a significant negative relationship between ALOS and ATCc [ALOS – ATCc (r_s = - .271, p = .016)], and for APRRs and ATCc, there was no statistically significant relationship [APRRs – ATCc (r_s = .065, p = .564)]. The multiple regression analysis showed there was no statistically significant relationship between the variables [ALOS – ARRs – ATCc (F (2,62) = 1.584, p = .211)]. The results showed that ALOS and APRRs do not necessarily predict ATCc. Consequently, based on the study results ATCc is not solely determined by ALOS and APRRs. The absence of a significant relationship between ALOS, APRRs, and ATCc does not necessarily indicate inefficiency in practice or lack of effectiveness. The results showed that there are other mediating factors impacting care that were not assessed in the study that need to be examined carefully which may have implications for practice, research, and methodology. Future research should be considered to determine these moderating factors to better understand the complex relationship between ALOS, APRRs, and ATCc. An understanding of these complex dynamics may inform managerial strategies and help with critical clinical and fiscal decisions in a healthcare setting.

Keywords: Average Length of Stay, Average Preventable Readmission Rates, Average Total Cost of care