Key result
Longer hospital LOS in heart failure is not independently linked to higher 30-day readmissions.
Why the study?
Does hospital length of stay affect the probability of 30-day readmission in patients hospitalized with heart failure?
Observational (n=516,768)
Yes
Does hospital length of stay affect the probability of 30-day readmission in patients hospitalized with heart failure?
Using instrumental variable analysis to control for omitted variable bias challenges the long-held belief that longer hospital length of stay inherently increases readmission rates in heart failure patients.
Should not yet alter LOS decisions in HF; challenges earlier observational findings by addressing omitted variable bias.
We estimate the effect of hospital length of stay (LOS) on the probability of 30-day readmission for 516,768 patients hospitalized with heart failure in California from 2005 to 2011. We use hospital crowding as an instrumental variable to control for bias from omitted health characteristics. Our results suggest that the literature, which has for 30 years identified readmission rates increasing with LOS, has not controlled for omitted variable bias when estimating the benefits from a patient’s hospital stay.
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Makowsky et al. (2017) conducted an observational in heart failure (n=516,768). Hospital length of stay (LOS) was evaluated on 30-day readmission. Hospital length of stay effects on 30-day readmission in 516,768 heart failure patients suggest prior studies identifying increased readmission with longer LOS suffer from omitted variable bias.
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