The hospital multistay rate as an indicator of quality of care

Objectives. To evaluate the hospital multistay rate to determine if it has the attributes necessary for a performance indicator that can be applied to administrative databases. Data Sources/Study Setting. The fiscal year 1994 Veterans Affairs Patient T reatment File (PTF), which contains discharge data on all VA inpatients. Study Design. Using a retrospective study design, we assessed cross-hospita l variation in (a) the multistay rate and (b) the standardized multistay ra tio. A hospital's multistay rate is the observed average number of hospital izations for patients with one or more hospital stays. A hospital's standar dized multistay ratio is the ratio of the geometric mean of the observed nu mber of hospitalizations per patient to the geometric mean of the expected number of hospitalizations per patient, conditional on the types of patient s admitted to that hospital. Data Collection/Extraction Methods. Discharge data were extracted for the 1 35,434 VA patients who had one or more admissions in one of seven disease g roups. Principal Findings. We found that 17.3 percent (28,300) of the admissions i n the seven disease categories were readmissions. The average number of sta ys per person (multistay rate) for an average of seven months of follow-up ranged from 1.15 to 1.4.5 across the disease categories. The maximum standa rdized multistay ratio ranged from 1.12 to 1.39. Conclusions. This study has shown that the hospital multistay rate offers s ufficient ease of measurement, frequency, and variation to potentially serv e as a performance indicator.