Abstract Details

Title The Bigger, the Better? Investigating the Relationship Between Hospital Bed Size and Length of Stay in Acute Stroke Care

Topic Neuro Trauma and Critical Care

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 18-007

Objective To investigate whether hospital bed size is associated with length of stay (LOS) for acute ischemic stroke patients treated with intravenous alteplase.

Background Acute ischemic stroke is a leading cause of morbidity and mortality worldwide. Hospital bed size serves as a proxy for healthcare facility capacity to provide specialized stroke care. Larger hospitals typically possess advanced technologies, higher staff-to-patient ratios, and specialized stroke units, which may influence patient LOS. Understanding how hospital resources affect stroke care could guide how to optimize stroke treatment.

Design/Methods We analyzed acute stroke data examining the relationship between hospital bed size and LOS. Following Shapiro-Wilk testing (p less than 0.001), data showed a non-normal distribution. We used the Kruskal-Wallis test to compare median LOS across five hospital bed size categories: fewer than 5 beds, 100-199 beds, 200-299 beds, 300-499 beds, and 500 or more beds. Post-hoc pairwise comparisons were conducted between all groups.

Results The Kruskal-Wallis test revealed a statistically significant relationship between hospital bed size and LOS (H² equals 7268.560, p less than 0.001). Smaller hospitals (fewer than 5 beds) consistently demonstrated longer LOS compared to all other categories (all adjusted p less than 0.001). Medium-sized hospitals (100-199 beds versus 200-299 beds) showed minimal LOS difference (test statistic equals negative 5.953). LOS decreased as bed size increased from 100-199 beds to 300-499 beds (test statistic equals negative 23.412, p less than 0.001). However, the largest hospitals (500 or more beds) demonstrated longer LOS compared to 200-299 bed facilities (test statistic equals negative 34.878, p less than 0.001).

Conclusions Hospital bed size significantly impacts LOS for acute stroke patients treated with alteplase, with optimal efficiency observed in moderately large hospitals (200-299 beds). Beyond this threshold, increasing hospital size correlates with longer LOS, potentially reflecting decreased staff-to-patient ratios.

Authors/Disclosures
Nipam N. Raval, BA PRESENTER	Ms. Raval has nothing to disclose.
misha polara, medical student	Ms. polara has nothing to disclose.
Sreeja Ponnam	Ms. Ponnam has nothing to disclose.
Dheera S. Rathikindi	Ms. Rathikindi has nothing to disclose.
Cassie A. Webb, MPH	Ms. Webb has nothing to disclose.
Ahmad Kareem Almekkawi (Saint Luke's Health System)	No disclosure on file

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