What is it about?
Since 2002 the apparent average length of stay (LOS) in the NHS has reduced. However a large part of this apparent reduction arises from the inclusion of 1.7 million same day stay emergency 'admissions' in the calculation of overnight LOS. The bulk of these same day stay emergency admissions arose after the introduction of the A&E 4 hour target in 2002. Hence something like suspected fetal problem (ICD-10 O36) has an apparent Los of 0.75 days but a real overnight LOS of 2.39 days.
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Why is it important?
Declining LOS has been the excuse for declining bed numbers. However available beds have declined far more so than the real overnight LOS.
Perspectives
Since the early 1990's all new hospitals built in the UK have been smaller than the ones they replaced. Declining average length of stay has been one of the reasons cited for the need for fewer beds, however, this assertion was based on highly flawed analysis of the data and the real overnight stay LOS is far, far higher. Part of a far longer series of papers on hospital bed planning and occupancy available at http://www.hcaf.biz/2010/Publications_Full.pdf
Dr Rodney P Jones
Healthcare Analysis & Forecasting
Read the Original
This page is a summary of: What is driving growth in the English NHS?, British Journal of Healthcare Management, March 2017, Mark Allen Group,
DOI: 10.12968/bjhc.2017.23.3.134.
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