Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals.

SUMMARY We did a retrospective study of 1920 episodes of community-acquired pneumonia (CAP) in 27 community hospitals and analysed inter-hospital variability in length of hospital stay (LOS), mortality and readmission rates. The overall adjusted LOS (mean +s.D.) was 10-0 ? 98 days. LOS increased according to the Pneumonia Severity Index (PSI) risk class: 7 3 days for class I to 11 3 days for class V (P < 0-00 1). In a multiple regression model, LOS increased (P < 0-001) according to the hospital (inter-hospital variability), PSI risk class, complications during hospitalization, admission to ICU, need of oxygen and transfer to a nursing home. Hospitals with shorter LOS did not show an increased readmission rate (adjusted OR 1-02, 95% CI 0-51-2-03, P=0-97) and post-discharge mortality (adjusted OR 1-20, 95 % CI 0-70-2-05, P=05 1). There are significant inter-hospital variations in LOS in patients with CAP which are related to differences in clinical management. The reduction of these differences will further improve efficiency and quality