Q&A: Discharge planner knowledge of ALOS and MS-DRGs

Q. Should a discharge planner know the average length of stay (ALOS) for specific Medicare severity diagnosis-related groups (MS-DRG)?

A. Discharge planners need this information only as a tool to manage resources and to facilitate setting targets for discharge days.

MS-DRGs are based on averages. This could mean patients are released before the ALOS 80% of the time and after the ALOS 10% of the time. The 10% remainder will have longer lengths of stay. To illustrate the point of averages, compare Hospital A with Hospital B. For Hospital A, of 100 patients in an MS-DRG with an ALOS of five days, 80% stay five days, 10% stay four days, and 10% stay six days. The patient days for that MS-DRG for that year at Hospital A is 420. For Hospital B, of 100 patients, 50% are discharged at five days, 25% at four days, and 25% at six days. The patient days at Hospital B is 500. Hospital A is more efficient having 80 days fewer for the same number of patients. With an ALOS of five days, this means that Hospital A can admit 16 more patients over the course of the year.

For more information, see Discharge Planning Guide: Tools for Compliance, Fourth Edition.

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