Intern Variation Drives Differences in Patient Hospital Stay Length
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A study of 996 patients over 1,125 hospitalizations on a general medicine service found that interns accounted for much of the variation in patient length of stay, even after controlling for patient characteristics. The study found that intern-level factors alone explained 49.3% of the observed variation in length of stay, while resident-level factors explained 9.5% and attending-level factors only 2.4%. Reducing the variation between interns, such as moving the interns with the longest patient stays to the median, could lower overall length of stay by up to 10%.
![Interns account for much of the variation in length of stay on a general medicine service C. Jessica Dine MD, Lisa M. Bellini MD, Theodore J. Iwashyna MD PhD Division of Pulmonary and Critical Care, Department of Medicine (CJD, LMB, TJI), Leonard Davis Institute of Health Economics (TJI), University of Pennsylvania School of Medicine, Philadelphia, PA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Objectives ,[object Object],[object Object],[object Object],[object Object],Methods ,[object Object],[object Object],Conclusions ,[object Object],[object Object],[object Object],Limitations ,[object Object],[object Object],[object Object],[object Object],Results ,[object Object],[object Object],Background ,[object Object],[object Object],Policy Implications Table: Potential Reductions in Overall Length of Stay from Reducing Variation Between Interns Duration of Hospitalization Average LOS Moving Bottom ¾ to 25 th Percentile Moving Bottom ½ to 50 th Percentile ≤ 28 days 6 days 23% (1.4 days) 10% (0.6 days) ≤ 14 days 5 days 25% (1.2 days) 9% (0.4 days)](https://image.slidesharecdn.com/iwashynajack-internsaccountformuchofthevariationinlengthofstayonageneralmedicine-5-20-08-100818145939-phpapp01/85/Interns-Account-for-Much-of-the-Variation-in-Length-of-Stay-on-a-General-Medicine-5-20-08-1-320.jpg)
