Climbing hospital stays level off in western U.S.

Three-year upward trend ends in 1999

Hospitals in the western United States have long been known for relatively short patient stays — a result of the heavy managed care insurance coverage in the area. But although the area’s hospitals release patients faster than anywhere else in the nation, the average length of stay (LOS) increased steadily between 1996 and 1998, drawing questions about whether this trend would continue and whether hospitals in the rest of the country would follow suit.

Getting some answers

New hospital LOS data from HCIA-Sachs, LLC in Baltimore provide some answers. (See graph, at right.) After two years of slight increases, average hospital stays in the West remained flat between 1998 and 1999. However, stays for patients in the remainder of the country are still declining.

The West’s previous slight upswing might be attributable to mandated minimum LOS for childbirth and newborns. Childbirth is the top reason for hospitalization among commercially insured populations.

These mandates have been in place for several years now, so their effects on LOS averages may already have been realized. But only time and careful analysis will tell whether 1999’s flattening average is the beginning of a new trend or a one-year anomaly.

HCIA-Sachs’ LOS data provide detailed information on hospital stays for the more than 23,000 diagnoses and procedures listed in the current versions of ICD-9-CM and CPT-4 codes. The standards are based on a detailed statistical analysis of all-payer data gathered from more than 12 million actual inpatient discharges annually.

Those data represent one of every three discharges from U.S. hospitals. The standards provide detailed LOS breakdowns by age and sex groups, simple vs. complex patients, and operated vs. nonoperated status.

More information on data from HCIA-Sachs is available from the company Web site at

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