Comparison of length of stay and hospital costs for Medicare patients before and after implementation of length of stay by parameters



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The hospital medical staff traditionally has been charged with the responsibility for the quality of care rendered to hospital patients. The decisions the physician makes concerning his patients determines the scope of hospital services used, the cost, and the quality of care. Community standards, type of patient, type of insurance or payment plan, and hospital management are other factors affecting hospital utilization. Since the study hospital was experiencing high Medicare utilization days, the Texas State Department of Health recommended that the Length of Stay Parameters by diagnoses established for Medicaid patients in 1972 also be used for Medicare patients. The purpose of this study was to compare pre-and post-parameter days with length of stay, number of drugs prescribed, drug and ancillary services (laboratory, X-Ray, EEG-EKG, medical supplies) usage and costs. Total hospital bills were also compared during the study period. In order to document these costs, the medical charts of the Medicare patients admitted with one or more of the five most common diagnoses were studied for a twenty-four month period, January 1, 1973 through December 31, 1974.