Influence of prolonged hospitalization on overall bed occupancy: a five-year single-centre study

Background: Effective bed use is crucial to an efficient NHS. Current targets suggest a decrease in mean occupancy as the most appropriate method of improving overall efficiency. The elderly and those suffering from complex medical problems are thought to account for a high proportion of overall bed occupancy. Aim: To assess the effect of prolonged hospital stay (4100 days) on overall bed occupancy in a modern teaching hospital. Design: Retrospective analysis. Methods: Analysis of all admission episodes (n 117178) over a five-year period in a large teaching hospital in a single UK region, serving a population of approximately 200 000. A logistic regression multi-factorial model was used to assess the effect of demographic and diagnostic variables on duration of stay. Results: A prolonged stay (4100 days) was seen in 648 admission episodes (0.6%). These accounted for 11 % of the overall bed occupancy over the 5-year period. Excluding all prolonged admission episodes from our analysis made no difference to the overall median length of stay. Discussion: Prolonged hospitalizations have a signif-icant impact on bed occupancy. Targeting these very long (4100 days) hospital stays may better improve overall efficiency, compared to targeting mean or median length of stay