Identifying Factors Related To Hospital Length Of Stay With Structural Equation Modeling

Identifying Factors Related To Hospital Length Of Stay With Structural Equation Modeling

INFORMS Healthcare Conference, Montreal, Canada

F800bb1e61b1a368d91a26c360cfa599?s=128

H. Kemal Ilter

June 22, 2011
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  1. Identifying Factors Related to Hospital Length of Stay with Multinomial

    Logistic Regression Rukiye Numanoglu Tekin and Halil Kemal İlter Baskent University, Ankara, Turkey June 22, 2011, INFORMS Healthcare Conference, Montreal, Canada
  2. 1 LoS 2 Research Methodology 3 Results 4 Conclusion 5

    Limitations and Future Work
  3. The number of days from hospital admission to the day

    the patient is discharged. (Kjekshus, 2005) LOS has become a valuable measure of outcomes following any operation or treatment, which also directly impacts on health services costs. (Baker et al., 2004) 1 LoS
  4. LoS can vary according to a wide range of factors,

    including Characteristics Patient Healthcare Providers Health System
  5. Gender Kurki et al., 2001; Krantz et al., 2008; Downing

    et al., 2009. Socioeconomic Status Clarke, 1996; Sepehri et al., 2006. Marital Status Clarke, 1996; Sepehri et al., 2006. Health Insurance Coverage McMillen Moinpour et al., 1990; Clarke, 1996; Mawajdeh et al., 1997; Somova et al. 2000; Sepehri, 2006. Disease Type Frantz et al., 1999; Somova et al., 2000; Chiu et al., 2003. Having More Severe Illness Downing et al., 2009. Type of Patient Hospitalization Asensio and Torres, 1999; Fontaine et al., 2011. Type of Surgery Cohen et al., 1999; Ghotbi and Ramsay, 1999; Schmelzer et al., 2008; Penel et al., 2008; Downing et al., 2009; Yıldız et al., 2009; Procter et al., 2010. Presence of Comorbidity or Physicatric Comorbidity Forrest et al., 1998; Furlanetto et al., 2003; Krantz et al., 2008; Downing et al., 2009; Ghali et al., 2009. Patient Age Hacker et al., 1990; McAleese and Odling-Smee, 1994; Schoetz et al., 1997.
  6. Hospital Bed Capacity Hedges et al., 1992; Kroneman and Nagy,

    2001; Krantz et al., 2008; Nawata et al., 2009. Hospital Ownership Hornbrook and Goldfarb, 1981; Mawajdeh et al., 1997; Chiu et al. 2003. Hospital Residental Area Collopy et al., 1991; Xiao et al., 1999; Nawata et al., 2009. Technological Developments Clarke, 1996; Sepehri et al., 2006. Health System Reimbursement Systems Theurl and Winner, 2007. Healthcare Providers
  7. None
  8. 2 Research Methodology Study population consisted of inpatients who stayed

    in Private hospitals, University hospitals, Other hospitals (municipality, association and foreigner/minority hospitals) MEDULA Data were taken from National Electronic Invoice System
  9. Patients Demographics (age, gender, social security status) Disease Classification According

    to ICD-10 Main Diagnosis Codes Type of Hospitalization Comorbidity Type and Number of Surgery Season of Hospitalization Hospital Ownership Hospital Bed Capacity Geographical Region of Hospital Residental Area of Hospital Type of Service
  10. SPSS 18.0 was used to perform statistical analysis. Backward Stepwise

    • Independent Sample T-Test • One Way Anova
  11. Number of inpatients 2.037.669 Age (average) 40.82 years LOS (average)

    4.08 days Female 58 % Men 42% 3 Results Mental and Behavioural Disorders 9.13 days Neoplasms 6.66 days Certain Conditions Originating in the Perinatal Period 6.46 days
  12. Length of Stay ≤ 2 > 2 * Backward Stepwise

    * Reference Category Dependent Variable
  13. Age 1 0-14 years 2 15-64 years 3 > 65

    * Gender 1 Female 2 Male * Bed Capacity 1 ≤ 100 beds 2 101-300 beds 3 > 301 beds * Ownership 1 University hospitals 2 Private hospitals 3 Foundation university hospitals 4 Other hopitals * Season 1 Spring 2 Summer 3 Autumn 4 Winter * last categories are reference category for all variables Independent Variables
  14. Type of Service 1 General Hospital 2 Hospital with Speciality

    * Comorbidity 1 Present 2 Absent * Geographical Region 1 Central Anatolia 2 Marmara 3 Aegean 4 Mediterranean 5 Black Sea 6 Eastern Anatolia 7 Southeastern Anatolia * Residental Area 1 Urban 2 Rural * Independent Variables
  15. -2 Log Likelihood Chi-Square df Sig. Intercept Only 536.363,30 Final

    102,205.06 434,158.24 20 .0001
  16. Pseudo R2 Cox and Snell .192 Nagelkerke .258 McFadden .156

  17. STEP SUMMARY Observed Predicted Length of Stay Percent Correct ≤

    2 days > 2 days Step 1 ≤ 2 days 938.779 222.891 80.8% > 2 days 360.929 515.070 58.8% Total (%) 63.8% 36.2% 71.3% Step 2 ≤ 2 days 944.169 217.501 81.3% > 2 days 371.678 504.321 57.6% Total (%) 64.6% 35.4% 71.1%
  18. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  19. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  20. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  21. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  22. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  23. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  24. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  25. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  26. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  27. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  28. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  29. B S.E. Wald Df P Exp(B) Intercept -1,047 ,025 1698,634

    1 ,0001 Sex (Female) -,080 ,003 592,389 1 ,0001 ,923 Age (0-14) ,469 ,005 7791,513 1 ,0001 1,598 Age (15-64) ,679 ,004 27352,751 1 ,0001 1,972 Bed Capacity (≤ 100) ,876 ,008 12062,211 1 ,0001 2,401 Bed Capacity (101-300) ,471 ,007 3969,878 1 ,0001 1,601 Hospital Ownership (University) ,000 ,021 ,001 1 ,982 1,000 Hospital Ownership (Private) 1,002 ,020 2464,859 1 ,0001 2,725 Hospital Ownership (Other) ,340 ,021 254,254 1 ,0001 1,406 Season (Spring) ,061 ,004 217,124 1 ,0001 1,063 Season (Summer) ,128 ,004 885,237 1 ,0001 1,136 Season (Autumn) ,160 ,005 901,277 1 ,0001 1,173 Type of Service (General) ,330 ,010 1135,015 1 ,0001 1,391 Comorbid (Presence) -,617 ,003 36436,684 1 ,0001 ,540 Region (Central Anatolia) -,613 ,006 8908,302 1 ,0001 ,542 Region (Marmara) -,532 ,006 8136,003 1 ,0001 ,587 Region (Aegean) -,525 ,007 5402,774 1 ,0001 ,591 Region (Mediterranean) -,640 ,006 9838,920 1 ,0001 ,527 Region (Black Sea) -,996 ,007 17700,849 1 ,0001 ,369 Region (Eastern Anatolia) -,213 ,007 808,988 1 ,0001 ,808 Residential Area (Urban) ,137 ,005 632,726 1 ,0001 1,147
  30. 4 Conclusion 0 + 1 + 2 𝐴𝐴 + 3

    𝐵𝐵 +4 𝑂𝑂𝑂 +5 𝑆𝑆𝑆𝑆𝑆𝑆 +6 𝑆𝑆𝑆𝑆𝑆 + 7 𝐶𝐶𝐶𝐶𝐶𝐶𝐶 +8 𝑅𝑅𝑅𝑅𝑅𝑅 + 9 𝐴𝐴 + =
  31. 5 Limitations and Future Work

  32. Identifying Factors Related to Hospital Length of Stay with Multinomial

    Logistic Regression Thank you Rukiye Numanoglu Tekin and Halil Kemal İlter Baskent University, Ankara, Turkey June 22, 2011, INFORMS Healthcare Conference, Montreal, Canada