Reduction Of The Average Length Of Stay In Internal Medicine: Difficult, But Not Impossible

Objective: To analyze the variables that influence the average length of stay (LOS), mortality and readmissions in an Internal Medicine Department (IMD) of a tertiary University Hospital.Method: Retrospective observational study of all patients admitted to an IMD from 2017 to 2019. The LOS, number of occupied beds, total number of admissions, urgent admissions, destination of the patient at discharge, hospital mortality, and early readmissions were analyzed. The age of the physicians, hours on call, work in the University and involvement in the plan of the multi-pathological patients (MPP) and the average delay of the diagnostic imaging procedures were collected. A descriptive analysis of the data was carried out.Results: 18,129 patients (mean age: 81 years) were studied. There was a progressive decrease in the LOS (8.6 days in 2017 and 6.4 in 2019; 26% reduction) and in overall mortality (12.9% in 2017 and 11.3% in 2019). The rate of early readmissions was maintained (around 15%). In the clinical wards, differences were observed in the LOS, related to the profile of the internists with respect to both the mean age, as well as the monthly number of hours on call, and participation in the MPP.Conclusion: We here present our experience in reducing LOS in an IMD. LOS is a key indicator to optimize hospital beds in periods of peak occupancy.