Time to Clinical Stability in Patients Hospitalized With Community-Acquired Pneumonia

Abstract

COMMUNITY-ACQUIRED pneumonia (CAP) is one of the most common inpatient medical conditions, accounting for more than 600000 hospital admissions in the United States each year.¹ Substantial variation in the length of hospital stay for CAP has been well documented within different regions, different hospitals, and even within hospitals.^2-6 These differences in length of stay persist even after adjusting for disease severity, comorbid conditions, and hospital characteristics, which suggests that clinical uncertainty and/or differences in physician practice style may be important and mutable determinants of management.^6-8 In addition, a physician survey of the discharge decision in CAP indicated that 22% of pneumonia inpatients remained in the hospital beyond reaching medical stability, indicating sizable opportunity for improving efficiency.⁹ For these reasons, providers and payers have been aggressively developing and implementing practice guidelines and critical pathways to reduce length of stay in pneumonia to decrease the cost of inpatient care.¹⁰