Skip to main content

Decision Support for Patient Discharge in Hospitals – Analyzing the Relationship Between Length of Stay and Readmission Risk, Cost, and Profit

  • Conference paper
  • First Online:
Services – SERVICES 2020 (SERVICES 2020)

Part of the book series: Lecture Notes in Computer Science ((LNPSE,volume 12411))

Included in the following conference series:

  • 394 Accesses

Abstract

Determining the optimal time for patient discharge is a challenging and complex task that involves multiple opposing decision perspectives. On the one hand, patient safety and the quality of healthcare service delivery and on the other hand, economic factors and resource availability need to be considered by hospital personnel. By using state-of-the-art machine learning methods, this paper presents a novel approach to determine the optimal time of patient discharge from different viewpoints, including a cost-centered, an outcome-centered, and a balanced perspective. The proposed approach has been developed and tested as part of a case study in an Australian private hospital group. For this purpose, unplanned readmissions and associated costs for episodes of admitted patient care are analyzed with regards to the respective time of discharge. The results of the analyses show that increasing the length of stay for certain procedure groups can lead to reduced costs. The developed approach can aid physicians and hospital management to make more evidence-based decisions to ensure both sufficient healthcare quality and cost-effective resource allocation in hospitals.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • AIHW: National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2018 (2018). https://meteor.aihw.gov.au/content/index.phtml/itemId/658485

  • Arefian, H., et al.: Extra length of stay and costs because of health care-associated infections at a German university hospital. Am. J. Infection Control 44(2), 160–166 (2016)

    Article  Google Scholar 

  • Benbassat, J., Taragin, M.: Hospital readmissions as a measure of quality of health care. Arch. Intern. Med. 160(8), 1074 (2000)

    Article  Google Scholar 

  • CMS: Readmissions Reduction Program (HRRP) (2016). https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html

  • DHHS: WIES25 weights 2018–19 (2018). https://www2.health.vic.gov.au/about/publications/FormsAndTemplates/wies-swies-calculator-2018-19

  • Eigner, I., Cooney, A.: A literature review on predicting unplanned patient readmissions. In: Wickramasinghe, N., Bodendorf, F. (eds.) Delivering Superior Health and Wellness Management with IoT and Analytics. HDIA, pp. 259–282. Springer, Cham (2019). https://doi.org/10.1007/978-3-030-17347-0_12

    Chapter  Google Scholar 

  • Eigner, I., Reischl, D., Bodendorf, F.: Development and evaluation of ensemble-based classification models for predicting unplanned hospital readmissions after hysterectomy. In: ACIS 2018 Proceedings (2018)

    Google Scholar 

  • Eigner, I., Tajak, L., Bodendorf, F., Wickramasinghe, N.: Readmission risk prediction for patients after total hip or knee arthroplasty. In: ACIS 2017 Proceedings (2017)

    Google Scholar 

  • Fetter, R.B., Shin, Y., Freeman, J.L., Averill, R.F., Thompson, J.D.: Case mix definition by diagnosis-related groups. Med. Care 18(2), Suppl. iii, 1–53 (1980)

    Google Scholar 

  • Hasan, O., et al.: Hospital readmission in general medicine patients: a prediction model. J. Gen. Intern. Med. 25(3), 211–219 (2010)

    Article  Google Scholar 

  • Heggestad, T.: Do hospital length of stay and staffing ratio affect elderly patients’ risk of readmission? A nation-wide study of norwegian hospitals. Health Serv. Res. 37(3), 647–665 (2002)

    Article  Google Scholar 

  • Horney, C., Capp, R., Boxer, R., Burke, R.E.: Factors associated with early readmission among patients discharged to post-acute care facilities. J. Am. Geriatr. Soc. 65(6), 1199–1205 (2017)

    Article  Google Scholar 

  • IHPA: HPA releases National Efficient Price and National Efficient Cost Determinations (2018). https://www.ihpa.gov.au/media-releases/ihpa-releases-national-efficient-price-and-national-efficient-cost-determinations

  • Kumar, A., et al.: Comorbidity indices versus function as potential predictors of 30-day readmission in older patients following postacute rehabilitation. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 72(2), 223–228 (2017)

    Article  Google Scholar 

  • Morris, D.S., et al.: The surgical revolving door: risk factors for hospital readmission. J. Surg. Res. 170(2), 297–301 (2011)

    Article  Google Scholar 

  • Oh, J.-H.C., Zheng, Z.E., Bardhan, I.R.: Sooner or later? Health information technology, length of stay and readmission risk. Prod. Oper. Manag. 27(11), 2038–2053 (2017)

    Article  Google Scholar 

  • Ohta, B., Mola, A., Rosenfeld, P., Ford, S.: Early discharge planning and improved care transitions: pre-admission assessment for readmission risk in an elective orthopedic and cardiovascular surgical population. Int. J. Integr. Care 16(2), 10 (2016)

    Article  Google Scholar 

  • Scott, I.A.: Preventing the rebound: improving care transition in hospital discharge processes. Aust. Health Rev. 34(4), 445–451 (2010)

    Article  Google Scholar 

  • Shadmi, E., Flaks-Manov, N., Hoshen, M., Goldman, O., Bitterman, H., Balicer, R.D.: Predicting 30-day readmissions with preadmission electronic health record data. Med. Care 53(3), 283–289 (2015)

    Article  Google Scholar 

  • Shulan, M., Gao, K., Moore, C.D.: Predicting 30-day all-cause hospital readmissions. Health Care Manag. Sci. 16(2), 167–175 (2013)

    Article  Google Scholar 

  • van Walraven, C., Bennett, C., Jennings, A., Austin, P.C., Forster, A.J.: Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ 183(7), E391–E402 (2011)

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Isabella Eigner .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Eigner, I., Bodendorf, F. (2020). Decision Support for Patient Discharge in Hospitals – Analyzing the Relationship Between Length of Stay and Readmission Risk, Cost, and Profit. In: Ferreira, J.E., Palanisamy, B., Ye, K., Kantamneni, S., Zhang, LJ. (eds) Services – SERVICES 2020. SERVICES 2020. Lecture Notes in Computer Science(), vol 12411. Springer, Cham. https://doi.org/10.1007/978-3-030-59595-1_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-59595-1_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-59594-4

  • Online ISBN: 978-3-030-59595-1

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics