The Determinants of Length of Stay in a University Hospital

ABSTRACT

Since nationwide compulsory health insurance started in 1977, shortage of hospital beds has become apparent and this is related in part to the length of hospital stay. To determine the factors which affect the length of stay a total of 1,003 in-patients medical records for appendectomy, cholecystectomy, and Cesarean section discharged in 1965, 1970, 1975 and 1980 from a university hospital were studied. The major findings are as follows; The average length of stay showed a statistically significant difference by year among the cholecystectomy and Cesarean section patients. For the appendectomies no statistically significant difference was found. Complications after surgical operation explained the length of stay mostly in all three procedures; the next factors were age, character of surgery, day of the week of surgery, and multiple diagnoses in this order for appendectomy; day of the week of surgery, age, type of accommodation, route of admission in this order for cholecystectomy; and day of the week of surgery, multiple diagnoses, residential area and type of accommodation in Cesarean section respectively.