Abstract
Asthma is a condition of significant public health concern associated with morbidity, mortality and healthcare utilisation. This study identifies key determinants of length of stay (LOS) associated with asthma-related hospital admissions in London, and further explores their effects on individuals. Subjects were primarily diagnosed and admitted for asthma in London between 1st January 2001 and 31st December 2006. All repeated admissions were treated uniquely as independent cases. Negative binomial regression was used to model the effect(s) of demographic, temporal and diagnostic factors on the LOS, taking into account the cluster effect of each patient's hospital attendance in London. The median and mean asthma LOS over the period of study were 2 and 3 days respectively. Admissions increased over the years from 8,308 (2001) to 10,554 (2006), but LOS consistently declined within the same period. Younger individuals were more likely to be admitted than the elderly, but the latter significantly had higher LOS (p<0.001). Respiratory related secondary diagnoses, age, and gender of the patient as well as day of the week and year of admission were important predictors of LOS. Asthma LOS can be predicted by socio-demographic factors, temporal and clinical factors using count models on hospital admission data. The procedure can be a useful tool for planning and resource allocation in health service provision.
Highlights
The morbidity and mortality associated with asthma places a high burden on health care infrastructure and services [1,2,3,4,5]
The majority (56.7%) of all admissions related to a person being admitted only once during the period 2001–2006; 17.4% of admissions were associated with a person being admitted twice, and 8.2% were associated with a person being admitted three times
From 2001 to 2006 the number of admissions steadily increased – 27% over the 6 year period. This increase was well in excess of the 5.9% growth in the population that occurred in London between 2001 and 2009 [34]
Summary
The morbidity and mortality associated with asthma places a high burden on health care infrastructure and services [1,2,3,4,5]. The UK together with the Republic of Ireland have the highest prevalence of asthma in the world [3]: it is the leading cause of hospital admissions among children [7], and disproportionately affects certain ethnic groups and demographics [2]. Length of stay (LOS) refers to the duration of a hospital admission (i.e. the difference in days between the date of admission and the date of discharge). It reflects several aspects of hospital care including the complexity of the case, the efficiency of hospital care, and the nature of hospital policies on admission and discharge [8,9,10,11,12,13,14]. LOS can be used as an indirect estimator of resource consumption and efficiency within the settings of a hospital, and has direct implications for overall healthcare planning and policy [5,9,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
