The hospital multistay rate as an indicator of quality of care

Nelda Wray, Nancy J. Petersen, Julianne Souchek, Carol M. Ashton, John C. Hollingsworth, Jane M. Geraci

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objectives. To evaluate the hospital multistay rate to determine if it has the attributes necessary for a performance indicator that can be applied to administrative databases. Data Sources/Study Setting. The fiscal year 1994 Veterans Affairs Patient Treatment File (PTF), which contains discharge data on all VA inpatients. Study Design. Using a retrospective study design, we assessed cross-hospital variation in (a) the multistay rate and (b) the standardized multistay ratio. A hospital's multistay rate is the observed average number of hospitalizations for patients with one or more hospital stays. A hospital's standardized multistay ratio is the ratio of the geometric mean of the observed number of hospitalizations per patient to the geometric mean of the expected number of hospitalizations per patient, conditional on the types of patients admitted to that hospital. Data Collection/Extraction Methods. Discharge data were extracted for the 135,434 VA patients who had one or more admissions in one of seven disease groups. Principal Findings. We found that 17.3 percent (28,300) of the admissions in the seven disease categories were readmissions. The average number of stays per person (multistay rate) for an average of seven months of follow-up ranged from 1.15 to 1.45 across the disease categories. The maximum standardized multistay ratio ranged from 1.12 to 1.39. Conclusions. This study has shown that the hospital multistay rate offers sufficient ease of measurement, frequency, and variation to potentially serve as a performance indicator.

Original languageEnglish (US)
Pages (from-to)777-790
Number of pages14
JournalHealth Services Research
Issue number3
StatePublished - Aug 1 1999


  • Hospital multistay rate
  • Performance indicator
  • Repetitive admission

ASJC Scopus subject areas

  • Nursing(all)
  • Health(social science)
  • Health Professions(all)
  • Health Policy


Dive into the research topics of 'The hospital multistay rate as an indicator of quality of care'. Together they form a unique fingerprint.

Cite this