Psychosocial factors as predictors of length of stay of Medicare patients under the prospective payment system.

The Prospective Payment System methodology is designed to predict inpatient hospital resource utilization. The system sets standards based on medical diagnosis (Diagnosis Related Groups), but it ignores psychosocial characteristics which often determine discharge options and therefore, directly affect a patient's length of stay. A study is described which examined the psychosocial characteristics of 234 elderly hospitalized patients in relation to length of stay and route of admission (elective or emergency room). Such data can be very useful to discharge planners in identifying high social risk patients, as well as to health planners attempting to modify the DRG methodology to incorporate psychosocial factors.