Prolonged Hospital Stays After Cystectomy Decreasing

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The likelihood of a prolonged hospital stay following radical cystectomy in the United States has decreased in the past decade, a study found.

The study also revealed that Medicaid and Medicare patients are significantly more likely to have a prolonged length of stay.

Marco Bianchi, MD, of the Urologic Research Institute in Milan, and colleagues studied the discharge patterns, including rates of prolonged length of stay and transfer to a facility, for 11,876 patients from the Nationwide Inpatient Sample who underwent a radical cystectomy between 1998 and 2007.

The researchers found that rates of prolonged stay decreased from 59% in 1998-2001 to 50% in 2005-2007, while transfer rates remained stable at 14%, according to a report published in The Journal of Urology (2012;187:1206-1209). Prolonged length of stay was 42% more likely among patients treated at hospitals with low annual caseloads compared with those treated at hospitals with high annual caseloads. Medicaid and Medicare patients were 66% and 17% more likely to experience a prolonged hospital stay, respectively. Rates of transfer were significantly higher for Medicaid and Medicare patients and for those treated at low annual caseload hospitals or nonacademic institutions.

“It is encouraging that the rates of prolonged length of stay have decreased while the rates of transfer to a facility remained stable. However, it is worrisome that individuals treated at low annual caseload centers as well as those with Medicare and Medicaid insurance experience less favorable discharge patterns,” the authors wrote.

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