Causes of prolonged hospital stay in patients with respiratory tract infection without complication

Abstract

Background : Official report from Prapokklao Hospital data base has been reported that 175 patients with DRG 04520 (respiratory tract infection/inflammation, no CC) during October 1, 2004 - September 30, 2005 had mean length of hospital stay as 10.64 days compare with standard mean length of hospital stay (4.12 days) of this group of patients.

Objective : To identify cause(s) of prolonged length of hospital stay in patients with respiratory tract infection/ inflammation without complication.

Methods : Patients with DRG 04520 discharged from department of medicine during October 2004, January, April and July 2005 was randomed systematicly to review clinical and demographic data. Diagnosis and ICD-10 codes of the samples had been reviewed and corrected then DRG of that patient were compared before and after comprehensive review.

Results : Fifty-four patients grouped as DRG 04520 has been selected. After comprehensive review, only 15 patients (27.78 percent, 95 percent, CI : 17.9 - 40.9 percent) remained unchanged DRG and mean length of stay for this group was 3.27 ± 2.87 days, not longer than standard mean. In patients that DRG had been changed, 31 pateints (57.4 percent of samples, 95 percent, CI : 46.4 - 68.4 percent) was grouped as respiratory tract infection/ inflammation with complication (DRG 04521-4) and 8 patients (14.8 percent of samples, 95 percent, CI : 6.9 - 22.7 percent) had disease that was not respiratory tract infection/ inflammation (wrong diagnosis).

Conclusions : Patients with DRG 04520 had mean length of stay not longer than standard mean length of stay for this group of patients. But incorrect and incomplete in-patient summary caused incorrect DRG and wrong patientûs selection for calculation of the mean length of hospital stay in previous official hospital report.