We did a retrospective study of 1920 episodes of community-acquired pneumonia (CAP) in 27 community hospitals and analysed inter-hospital variability in length of hospital stay (LOS), mortality and readmission rates. The overall adjusted LOS (mean±S.D.) was 10·0±9·8 days. LOS increased according to the Pneumonia Severity Index (PSI) risk class: 7·3 days for class I to 11·3 days for class V (P<0·001). In a multiple regression model, LOS increased (P<0·001) according to the hospital (inter-hospital variability), PSI risk class, complications during hospitalization, admission to ICU, need of oxygen and transfer to a nursing home. Hospitals with shorter LOS did not show an increased readmission rate (adjusted OR 1·02, 95% CI 0·51–2·03, P=0·97) and post-discharge mortality (adjusted OR 1·20, 95% CI 0·70–2·05, P=0·51). There are significant inter-hospital variations in LOS in patients with CAP which are related to differences in clinical management. The reduction of these differences will further improve efficiency and quality of care.
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