Relation between length of hospital stay and costs of care for patients with community-acquired pneumonia

PURPOSE: Patients with pneumonia often remain hospitalized after becoming c linically stable, without demonstrated benefits on outcome. The purposes of this study were to assess the relation between length of hospital stay and daily medical care costs and to estimate the potential cost savings associ ated with a reduced length of stay for patients with pneumonia. SUBJECTS AND METHODS: As part of a prospective study of adults hospitalized with community-acquired pneumonia at a community hospital and two universi ty teaching hospitals, daily medical care costs were estimated by multiplyi ng individual charges by department-specific cost-to-charge ratios obtained from each hospital's Medicare cost reports. RESULTS: The median total cost of hospitalization for all 982 inpatients wa s $5,942, with a median daily cost of $836, including $491 (59%) for room a nd $345 (41%) for non-room costs. Average daily non-room costs were 282% gr eater on the first hospital day, 59% greater on the second day, and 19% gre ater on the third day than the average daily cost throughout the hospitaliz ation (all P < 0.05), and were 14% to 72% lower on the last 3 days of hospi talization. Average daily room costs remained relatively constant throughou t the hospital stay, with the exception of the day of discharge. A projecte d mean savings of $680 was associated with a 1-day reduction in length of s tay. CONCLUSIONS: Despite institutional differences in total costs, patterns of daily resource use throughout hospitalization were similar at all instituti ons. A 1-day reduction in length of stay might yield substantial cost-savin gs. (C) 2000 by Excerpta Medica, Inc.