Chart of the week: How long do Covid-19 patients spend in hospital?

Each week we present analysis of data in chart form to illustrate some key issues and invite discussion. Developments in knowledge and treatments for Covid-19 has led to a perception in some quarters that most coronavirus patients in recent months would be spending a shorter time in hospital than would have been the case at the beginning of the pandemic. But is it that straightforward? Sarah Scobie and Eilís Keeble look at the data from last year and discuss the factors affecting length of hospital stay for Covid-19.

Data story

Published: 26/02/2021

We are past the peak of the second wave, and admissions to hospital for people with Covid-19 have fallen by two thirds in the past five weeks.  But over 14,000 people with Covid-19 are still in hospital – that's about 1 in 8 of all hospital patients in England.

The number of people in hospital is a reflection not just of the number of admissions, but also of how long those people stay. Our chart plots the median length of stay for Covid-19 patients discharged between March and December 2020, along with the number of patients who were discharged, were transferred or died.

The median hospital stay for Covid-19 patients over the whole period was 7 days. By comparison, in 2019 the median stay for general medicine admissions was only 1 day, while for patients with a flu-related diagnosis it was 5 days.  The high proportion of patients still in hospital with Covid-19 reflects their relatively long lengths of stay.

Length of stay has fluctuated over the pandemic, reaching 11 days for Covid-19 patients discharged in June.  By June there were fewer new admissions, so many of the people discharged at that point were the most severely ill patients from earlier months –  a quarter of patients had spent more than 26 days in hospital. By September, almost all patients from the first wave had been discharged, so most patients discharged at this stage would have been people recently admitted.

Since September, the length of stay of patients has been rising again, along with the number of Covid-19 patients. By December, length of stay was already higher than at the peak of the first wave in April.

Increasing lengths of stay partly reflect the cumulative effect of patients with more severe illness from previous months.  In addition, a fifth of patients may have been infected with Covid-19 in hospital – these patients will have a longer length of stay, because they will already have spent some time in hospital before being infected.

Treatments for Covid-19 have improved over time, which has improved survival and could reduce hospital stays for some patients.  More treatments are now also available for patients outside of hospital – which may in turn reduce length of stay.

The surge in hospital admissions in January – driven by a surge in case numbers, rather than greater severity – could see lengths of stay increasing further. We can expect hospitals to be managing a large number of Covid-19 patients for some time to come.

Median length of stay for Covid-19 hospital patients in 2020 26/02/2021

Chart

Note:  

Median has been used instead of the average, because the data is skewed with some very, very long stay patients, so the median is a better measure.

Covid-19 discharges were defined as any discharge from hospital where a diagnosis code of “U071” or “U072” had been recorded at any point during the hospital stay.

Same day discharges had a length of stay of zero.

Source:  

Hospital Episode Statistics data (year range 2019/20 to 2020/21) Copyright © 2020, re-used with the permission of NHS Digital. All rights reserved.

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About the data

  • Covid-19 discharges were defined as any discharge from hospital where a diagnosis code of “U071” or “U072” had been recorded at any point during the hospital stay.
  • Same-day discharges had a length of stay of zero.
  • Median has been used instead of the average, because the data is skewed with some very, very long stay patients, so the median is a better measure.
  • Hospital Episode Statistics data (year range 2019/20 to 2020/21) © 2020, re-used with the permission of NHS Digital. All rights reserved.

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