Influences on length of stay in intermediate care: lessons from the nursing-led inpatient unit studies

A recent study found that intermediate care in a nursing-led in-patient unit (NLIU) led to dramatically increased hospital stay when compared to usual care in a hospital. This is despite a large body of work across a variety of settings, including the pilot for that same study, which suggests that the NLIU is effective. This paper presents a series of exploratory analyses that aim to explore the findings further. A number of changes were identified in the functioning of the NLIU between the main and pilot study including patient population, leadership and staffing levels. Two ANCOVA analyses reveal that while performance of the NLIU declined between the two studies, that of usual care improved dramatically. Extended lengths of stay appear to be associated with the NLIU's location on a satellite site rather than the model of care per se. Reduction in the staffing levels on the NLIU and a change in patient population may well explain the findings.