What affects length of hospital stay? A case study from Malta
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 20 September 2019
Issue publication date: 18 October 2019
Abstract
Purpose
Hospital length of stay (LOS) is not only a function of patient- and disease-related factors, but is also determined by other health system-wide variables. Managers and clinicians strive to achieve the best possible trade-off between patients’ needs and efficient utilisation of hospital resources, while also embracing ethical decision making. The purpose of this paper is to explore the perceptions of the hospital’s major stakeholders as to what affects the duration of LOS of inpatients.
Design/methodology/approach
Using a data-triangulated case study approach, 50 semi-structured interviews were performed with management, doctors, nurses and patients. Additionally, the hospitals’ standard operating procedures, which are pertinent to the subject, were also included in the thematic analysis.
Findings
This study shows that LOS is a multi-dimensional construct, which results from a complex interplay of various inputs, processes and outcomes.
Research limitations/implications
The findings emerging from a single case study approach cannot be generalised across settings and contexts, albeit being in line with the current literature.
Practical implications
The study concludes that a robust hospital strategy, which addresses deficient organisational processes that may unnecessarily prolong LOS, is needed. Moreover, the hospital’s strategy must be sustained by providing good primary care facilities within the community set-up, as well as by providing more long-term care and rehabilitation beds to support the hospital turnover.
Originality/value
The subject of LOS in hospitals has so far been tackled in a fragmented manner. This paper provides a comprehensive and triangulated account of the complexities surrounding the duration in which patients are kept in hospital by key stakeholders, most of whom were hands-on in the day-to-day running of the hospital under study.
Keywords
Citation
Abela, L., Pace, A. and Buttigieg, S.C. (2019), "What affects length of hospital stay? A case study from Malta", Journal of Health Organization and Management, Vol. 33 No. 6, pp. 714-736. https://doi.org/10.1108/JHOM-10-2018-0280
Publisher
:Emerald Publishing Limited
Copyright © 2019, Emerald Publishing Limited