Several decades ago, the introduction of the prospective payment system by diagnosis-related
groups created a tremendous incentive for hospitals to shorten length of stay. Suddenly,
there was a new person rounding with each inpatient team, paid for by hospital administration.
These were “discharge planners,” and their job was to get physicians thinking about
how to discharge a patient expediently even as they were writing admission orders.
Rapidly, US hospitals pivoted to focus on short, procedure-heavy service provision,
in contrast to many other countries, in which hospitals continue to offer a more leisurely
process of patient evaluation or convalescence, leading to the unsurprising finding
that a couple of extra days in the hospital is an effective strategy for minimizing
rehospitalization.
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February 15, 2022
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