Factors Associated with length of stay variations and cost in orthopedic inpatients

Abstract

Introduction: Introduction: Musculoskeletal disorders are the most common cause of severe, long-term pain, and
physical disability, affecting hundreds of millions of people, regardless of age, gender, and socio-demographic status
worldwide. They represent a significant burden on the individual, society, and health services, and are particularly
costly for those. Various factors have been associated with the overall length of hospitalization of patients with
musculoskeletal disorders, related to both the individual patient and the health care itself. Aim: The aim of this study
is to identify the characteristics of patients with musculoskeletal disorders, and to identify those characteristics of
patients and the hospital that are related to the duration and cost of treatment. Material and Method: The sample
consisted of 10% of the total of patients admitted to the orthopedic clinic of a Greek public hospital from 1/1/2012 to
31/12/2017 (validity 90%, significance level 95%), the selection of whom was done by random sampling by a random
number generation software. The statistical processing of the empirical research material was carried out with the
software program Statistical Package for the Social Sciences, 20.0 (S.P.S.S. Inc., Chicago, IL, USA), using the methods of
Descriptive and Inferential Statistics. Results: The sample of the present study consisted of 634 patients, with a mean
age of 62.8 ± 19.4 years. 59.8% of the patients were women. Fractures accounted for 52.2% of orthopedic clinics. The
average length of hospitalization of patients in the orthopedic clinic amounted to 4.58 ± 4.57 days, while its average
total cost was 2083.32 ± 1756.66 €. Various factors were statistically correlated significantly with the total actual cost
of hospitalization, including gender (t(554)=-3,834, p<0.001), age (r=0.288, p<0.001), marital status (F(4,626)=4,781,
p<0.001), profession (F(5,626)=2.408, p<0.05), diagnosis (t(627)=-4.671, p<0.001) as well as the performance of a medical
operation (t(629)=6.903, p<0.001) or surgery (t(628)=9.388, p<0.001). Respectively, the duration of hospitalization was
correlated with age (r=0.215, p<0.001), the diagnosis of fracture (t=(627)=2.894, p<0.01) as well as with the performance
of surgery during the hospitalization (t=(628)=3,500, p<0.001). Conclusions: The characteristics of orthopedic patients
and their therapeutic approach are important determinants of both their cost and the duration of hospitalization.