Uncomplicated pneumonia: an evaluation of determinants of length of hospitalization.

A study was carried out on the length of hospitalization of patients with uncomplicated pneumonia. Three medical wards with comparable admissions criteria and characteristics of patients had different lengths of hospitalization (5.4, 8.1 and 9.1 days). Quality of care, defined by a score based on agreed-upon criteria of patient management and scored by independent observers, was similar for the three wards. There were also no differences in the rates of rehospitalization or complications. In the ward with the shortest hospital stay, predischarge chest X-rays were not performed; in the other two wards, 19.8% of the patients had a repeat chest X-ray before discharge. The difference in the proportion of predischarge X-rays did not explain the differences in length of stay. The data suggest that hospitalization practices should be periodically reviewed to ascertain their contribution to the length of hospitalization. The shortest hospitalization period for uncomplicated pneumonia observed on one of the medical wards seems reasonable and was not associated with obvious major complications in this small group of patients. Since only a small percentage of chest X-rays return to normal by the end of the 1st wk, and in view of their questionable contribution to therapeutic decisions, the usefulness of the predischarge chest X-ray is doubtful.