LONGER HOSPITAL LENGTH OF STAY IS NOT RELATED TO BETTER CLINICAL OUTCOMES IN CONGESTIVE-HEART-FAILURE

Efforts to reduce hospital lengths of stay (LOS) are prevalent, despit e limited understanding of the clinical impact of duration of hospital ization. Thus, we sought to evaluate the clinical relevance of LOS in congestive heart failure (CHF) by studying its relationship to inpatie nt and post-discharge outcomes among individuals with this disorder, T en acute care community hospitals in New York State participated in th is investigation, The study population consisted of 1,402 consecutive patients, predominantly elderly, who were hospitalized for evaluation and treatment of moderately severe or severe CHF, The patients' medica l records were abstracted by trained personnel immediately after hospi tal discharge, Patients were followed forward for six month's time to track death and readmission rates, as well as functional status, quali ty of life, and satisfaction, Mean LOS for the group was 7.9 +/- 9.2 d ays, Longer LOS had a neutral or negative association with patient out comes, Specifically, longer LOS was linked to a higher adjusted mortal ity rate during the index hospitalization, as well as a greater adjust ed risk of death during the post-discharge period, Moreover, longer LO S was associated with worse post-discharge functional class and a tren d for less patient satisfaction with their physicians' care, We conclu de that death becomes more prevalent and functional measures decline i n association with prolonged hospital stays for heart failure, Althoug h these findings may be of use in planning management strategies, they offer no proof that reducing the costs of care will improve clinical outcomes in CHF.