Is length of stay a reliable efficiency measure?

Abstract

344 British Journal of Healthcare Management 2015 Vol 21 No 7 © 2 01 5 M A H ea lth ca re L td seen commencing around May of 2007. This step-like change in admissions leads to 10% higher admissions in every month from May 2007 through to September 2008. after which admissions step down to the underlying trend. Somewhere around one to two months later, deaths show a similar step-like increase while bed days increase around the same point that deaths increase. It is also clear from Figure 1 that this particular outbreak had a far greater effect on morbidity than mortality and this concurs with existing knowledge regarding the outbreaks (Jones, 2015a; e). The actual effect upon LOS is complicated by the fact that average LOS in Belfast commences a longerterm trend downward in 2006 as measures to reduce LOS were introduced across the whole of Northern Ireland. Hence, the stepchange in LOS appears to occur later than in reality and its magnitude is diminished by underlying LOS initiatives. Nevertheless, LOS shows a step-like change as do all the other parameters. Admissions probably contain a time cascade of conditions/complexity and never fully return to the baseline position after deaths have dropped back (Jones, 2015b). This event seen in 2007, in Belfast, swept across the entire UK with deaths for the UK as a whole peaking in the 2008 calendar year (Jones, 2015a–b)—which has never been officially explained. In Rod Jones Is length of stay a reliable efficiency measure?