Robinson, Alysia2020-08-072020-08-072020-08-07http://hdl.handle.net/10222/79620Objective: Adjusted hospital length of stay (LOS), widely used to benchmark hospital efficiency, does not account for community-driven variation. We estimate the extent to which community affects LOS for unplanned hospitalizations, whether this differs by complex needs, and identify communities significantly different from the provincial average. Methods: The outcome is LOS, adjusted for demographics and disease case-mix. Variation in LOS explained by community of residence is estimated using random intercept regression. Complex needs are defined using Elixhauser and Resource Intensity Weights. Small-area empirical Bayes estimates are calculated and mapped. Results: Community of residence is associated with adjusted LOS, and its effect differ by complex needs. Of 77 communities, 17 had an adjusted LOS differing from the provincial average. Conclusion: The community to which patients are discharged is associated with hospital LOS. Research is needed to understand why these communities are associated with longer or shorter adjusted LOS.enHospital Length of StaySmall Area Rate VariationEpidemiologyHealth Services ResearchNova ScotiaCommunities as Systems of CareThesis