Veterans Health Administration
Shorter Hospital Stays Are Better for Patients, VA Finds
“Here at VA weâ€™re trying to provide the best patient-centered care possible. We want to get you diagnosed. We want to get you treated. We want to get you home.” — Dr. Peter Kaboli, VA hospitalist
A shorter stay in the hospital can actually be more beneficial to you than a longer stay, according to a recent VA study that appeared in the December 18, 2012 issue of Annals of Internal Medicine.
â€śThis study shows that a large health care system like VA can improve both quality and efficiency to provide better, more cost-effective care,â€ť said Dr. Peter Kaboli, a hospitalist at the Iowa City VA Health Care System and the studyâ€™s lead researcher. â€śUltimately the focus should not be how long a patient is in the hospital, but ensuring they get the care they need as efficiently as possible and get them out of the hospital as soon as they are ready.â€ť
Kaboli and his research team came to this conclusion after examining the records of over four million Veterans hospitalized at 129 VA medical centers between 1997 and 2010.
â€śPeople come to the hospital for all kinds of medical conditions, so for our study we looked at everybody,â€ť the researcher said. â€śBut we also zeroed in on some of the more common health issues like heart failure and pneumonia.â€ť
As the study progressed, an interesting pattern began to emerge: hospital stays at VA decreased by almost 30 percent over a period of about 14 years.
â€śWe initially thought this might translate into higher readmission rates and death rates,â€ť Kaboli said. â€śIt turned out to be just the opposite: readmission rates went down by 16 percent. Death rates went down by three percent.â€ť
â€śCreative research of this nature is a major factor leading to continuous improvement of the medical services we provide to our Nationâ€™s Veterans.â€ť
— Dr. Joel Kupersmith, VA Chief Research & Development Officer
The take-away from all this? â€śThe individual needs to be in the hospital for as long as it takes to address their medical issues, and no longer,â€ť Kaboli observed. â€śEveryone is different…one patient might be able to go home within 48 hours. Another patient might not be able to go home for five days.â€ť
Kaboli said VAâ€™s success in lowering readmission rates while simultaneously reducing hospital stays points to an increased level of efficiency. He attributes this increased efficiency to three big factors.
â€śFirst, throughout VA weâ€™ve been working hard on improving the coordination that occurs between the hospital and our outpatient services,â€ť he explained. â€śSuccessfully transitioning out of the hospital into outpatient care is so critical. The patientâ€™s health and well-being depend on this transition being done correctly.
â€śSecond,â€ť he continued, â€śweâ€™re working hard on constantly improving the quality of the care we provide. For example, care at VA is now delivered by Patient Aligned Care Teams — a team of specialists who coordinate closely with one another regarding the patientâ€™s case. The patient is a big part of this team.â€ť
The third big factor? Specialization.
â€śVA has adopted the use of hospitalists at over 80 percent of our medical centers,â€ť Kaboli said. â€śHospitalists are physicians who specialize in the care of hospitalized patients. Care delivered by hospitalists has been shown to be more efficient and can result in higher quality health care.â€ť
Kaboli said quality health care occurs when everyone — the patient, the patientâ€™s family, and hospital staff — are communicating with one another.
â€śIn the end,â€ť he said, â€śitâ€™s all about listening to the patient so we can determine what their needs are, what their goals are. The patient needs to be at the center of the whole process.â€ť