Reducing the length of stay of patients in the hospital: a cost control strategy

Monitoring the performance of hospitals is one of the most important actions of the insurer in order to cost control. The aim of this study was to investigate the effect of Monitoring in reducing the average length of hospital stay through the control of services and unnecessary hospitalizations in hospitals contracted supplementary insurance company.

this study is a semi-experimental type, that was conducted using before and after design in 22 provinces. presence at the 15,721 patient’s bedside in 103 hospitals, insurance experts examined the medical records and the treatment process using a researcher-made questionnaire. According to the initial results, supervisory interventions were carried out in two ways: “ hospital discharge “ or “ non-approval of medicine and consumables “. before and after data of the study were analyzed through paired t-test using R-Studio version 9.2 software.

According to the findings, 85.3% (n=13,401) of the hospitalizations did not require supervisory intervention and 14.7% (2320 patients) had supervisory interventions. Based on the ownership, the highest rate of unnecessary hospitalization was in private hospitals (80درصد; (n=1850)) and the highest rate of monitoring interventions was related to discharge from the hospital (46% of the financial savings of monitoring interventions). Non-approval of medicine and consumables has been the most frequent (1,102; 47.5%). The average length of stay and standard deviation were 23.74 and 48.58 before the intervention and 10.69 and 12.14 after the intervention.

continuous monitoring of hospitals, especially using the appropriateness evaluation protocol, will significantly reduce the average length of stay of patients.