Evaluation of the length of hospital stay in cases of coronary artery bypass graft by payer

Abstract

Objective

The length of hospital stay (LOS) allows for the evaluation of the efficiency of a given hospital facility, as well as providing a basis for measuring the number of hospital beds required to provide assistance to the population in a specific area.

Methods

A retrospective survey was conducted on a database of 3,010 patients submitted to coronary artery bypass graft (CABG) from July, 2009 to July, 2010.

Results

Among 2,840 patients that met the inclusion criteria, 92.1% had their surgery paid by the Brazilian Unified Health System (Sistema Único de Saúde - SUS) and 7.9% by health plans or themselves (non-SUS). 70.2% were male, the average age was 61.9 years old, and the average risk score (EuroScore) was 2.9%. The SUS and the non-SUS groups did not differ regarding the waiting time for surgery (WTS) (2.59 ± 3.10 vs. 3.02 ± 3.70 days for SUS and non-SUS respectively; p = 0.790), but did differ with respect to the length of stay in intensive care unit (2.17 ± 3.84 vs. 2.52 ± 2.72 days for SUS and non-SUS respectively; p < 0.001), the postoperative period (8.34 ± 10.32 vs. 9.19 ± 6.97 days for SUS and non-SUS respectively; p < 0.001), and the total LOS (10.93 ± 11.08 vs. 12.21 ± 8.20 days for SUS and non-SUS respectively; p < 0.001). The non-SUS group had more events of non-elective surgery (p = 0.002) and surgery without cardiopulmonary bypass (p = 0.012). The groups did not differ regarding the associated valve procedure (p = 0.057) nor other non-valve procedures (p = 0.053), but they did differ with respect to associated non-cardiac procedures (p = 0.017). ICU readmission (p = 0.636) and postoperative complications rates were similar in both groups (p = 0.055).

Conclusion

The Non-SUS group showed longer LOS compared to the SUS group.