Relationships between wheelchair provision time for hospital inpatients and their lengths of stay and costs of hospitalization: a cohort study.

Abstract

Objectives: To test the hypotheses that Wheelchair Provision Time (WPT) (from when a loaner wheelchair was ordered to when the wheelchair arrived at the hospital site) has a significant relationship with Length of Stay (LOS) and total Cost of Hospitalization (COH).

Design: Cohort study.

Setting: Hospital inpatient units in the Central Zone of Nova Scotia Health (NSH).

Participants: 97 inpatients.

Intervention: Order for loaner wheelchair placed during their admissions.

Main outcome measures: Demographic, clinical and process data from four available databases from which we derived WPT, LOS and COH. To test the hypotheses, we used Spearman correlation coefficients, negative binomial regression for LOS (n = 90) and linear regression for COH (n = 69).

Results: The median values for WPT, LOS and total COH were 3.8 days, 51.0 days and $43,062 Canadian dollars (CADs). Multivariable regression revealed that WPT was associated to a statistically significant extent with LOS (p = 0.0049) (a 18% increase in LOS for each additional day in WPT), but not with COH. However, LOS was associated to a statistically significant extent with COH (p < 0.0001). The Spearman correlation between LOS and COH was 0.8915 (p < 0.0001).

Conclusions: Statistically significant associations exist between WPT and LOS and between LOS and COH. Although this study does not establish causality and further research is needed, our findings suggest that more rapid provision of loaner wheelchairs to hospital inpatients could have a positive impact on the health-care system.