A community-based analysis of regional differences in hospital stays by diagnosis related group

Most research on regional differences in hospital stays focuses on systemwide influences, the relative availability of hospital beds, and utilization control mechanisms. In this study, we used a different approach to account for utilization differences between Sacramento, California, and Syracuse, New York: by comparing hospital mean stays at the aggregate level and by diagnosis related groups. We conclude that the shorter mean stays in Sacramento, at both the aggregate and the DRG-specific levels, were produced by a complex variety of factors rather than by systemwide differences in demographics, institutional bed availability, or health maintenance organization penetration. We also found that the largest differences between stays in the two areas were associated with DRGs containing large numbers of elderly, nonsurgical patients.