COMPUTER-GENERATED INFORMATIONAL MESSAGES DIRECTED TO PHYSICIANS - EFFECT ON LENGTH OF HOSPITAL STAY

Objective: With the advent of hospital payment by diagnosis-related gr oup (DRG), length of stay (LOS) has become a major issue in hospital e fforts to control costs. Because the Columbia-Presbyterian Medical Cen ter (CPMC) has had above-average LOSs for many DRGs, the authors teste d the hypothesis that a computer-generated informational message direc ted to physicians would shorten LOS. Design: Randomized clinical trial with the patient as the unit of randomization. Setting and Study Popu lation: From June 1991 to April 1993 , at CPMC in New York, 7,109 pati ent admissions were randomly assigned to an intervention (informationa l message) group and 6,990 to a control (no message) group. Interventi on: A message giving the average LOS for the patient's admission or pr ovisional DRG, as assigned by hospital utilization review, and the cur rent LOS, in days, was included in the main menu for review of test re sults in the hospital's clinical information system, available at all nursing stations in the hospital. Main Outcome Measure: Hospital LOS. Results: The median LOS for study patients was 7 days. After adjustmen t for covariates including age, sex, payor, patient care unit, and tim e trends, the mean LOS in the intervention group was 3.2% shorter than that in the control group (p = 0.022). Conclusion: Computer-generated patient-specific LOS information directed to physicians was associate d with a reduction in hospital LOS.