Longer Patient Stays Can Reduce Costs, Study Finds

NEW YORK — New evidence shows that keeping patients in the hospital one day longer can significantly cut readmissions, save patient lives and reduce costs.

Research from a September 2014 Columbia Business School study titled, “Should Hospitals Keep Their Patients Longer? The Role of Inpatient and Outpatient Care in Reducing Readmissions,” compared the impact of a longer length of stay in the hospital to the effects of outpatient care for Medicare patients.

The study showed that one additional day in the hospital can reduce mortality risk by 22 percent for patients treated for pneumonia and by 7 percent for heart attack patients. It can also result in five to six times more lives being saved when compared with outpatient care and decrease readmission rates by 7 percent for severe heart-failure patients.

What’s more, the study showed that one extra day in the hospital would, in many cases, cost less overall than the associated outpatient care required with early discharge. The vast number of Medicare patients being readmitted to the hospital within 30 days of discharge is costing taxpayers at least $17 billion annually.

“Currently, about one in every five Medicare patients is readmitted to the hospital,” said Carri Chan, associate professor of decision, risk, and operations at Columbia Business School, in a statement. “Our findings show that one extra day in the hospital could reduce these readmission rates, ensure healthier patients and save money.”

As part of the 2010 Affordable Care Act, the Hospital Readmissions Reduction Program financially penalizes hospitals with higher than expected readmissions. Researchers looked at data on more than 6.6 million Medicare patients treated between 2008 and 2011, and estimated the reductions in readmission and mortality rates of an inpatient intervention (keeping patients in the hospital for an extra day) versus providing outpatient interventions.

Since the focus of the Affordable Care Act’s Hospital Readmissions Reduction Program has been to reduce readmissions of only those patients with heart failure, myocardial infarction or pneumonia, the study focused on these three distinct patient populations.

“Given the stiff penalties imposed under the Affordable Care Act, hospitals are implementing a variety of approaches to aggressively reduce readmission rates, most commonly involving outpatient care,” said Ann P. Bartel, professor of finance and economics at Columbia Business School, in a statement. “While some types of outpatient interventions can be effective, our study shows that hospitals should consider keeping some of their patients in the hospital longer to better control patient care, reduce readmissions and ensure fewer deaths.”