Hospitalized patients admitted to a tertiary care medical center in Golestan, Iran, recorded an average length of stay of 5.13 days, according to a retrospective observational study evaluating routinely collected health data. The investigation analyzed 17,474 eligible inpatient records registered across all hospital departments at Shahid Sayyad Shirazi Hospital in Gorgan over a single twelve-month timeframe from March 20, 2024, to March 19, 2025. The research team reported that the measured mean duration of 5.13 days exceeded the general national benchmark of 4 days for inpatient admissions. However, the study authors explicitly noted that this comparison with the national benchmark must be interpreted with caution because the collected data were not adjusted for patient case mix.

The study’s rationale centered on length of stay as a critical operational indicator of hospital efficiency and healthcare resource utilization. In tertiary care environments, inpatient medical services account for a substantial portion of total healthcare expenditures, making the duration of patient admissions an essential administrative metric. By examining records collected across all medical departments at Shahid Sayyad Shirazi Hospital, the researchers sought to evaluate the actual duration of patient hospitalizations and identify the demographic, clinical, economic, and managerial factors associated with length of stay within this regional tertiary care setting.

To evaluate these hospital patterns, the investigators carried out a retrospective, hospital-based observational study utilizing electronic records archived in the facility’s Hospital Information System. The analyzed dataset captured all eligible inpatient admissions registered across every hospital department throughout the twelve-month observation period. In their methodological design, the researchers evaluated demographic, clinical, economic, and managerial variables through descriptive statistics, non-parametric tests, and generalized linear modeling.

Across the analyzed sample of 17,474 inpatient records, the observed length of stay displayed a highly right-skewed distribution among admitted individuals. The overall cohort demonstrated a mean length of stay of 5.13 ± 6.17 days alongside a median duration of 3 days. When these patient records were evaluated within the multivariable negative binomial regression model, several patient characteristics emerged as statistically significant independent predictors of inpatient duration. Specifically, patient age, marital status, basic health insurance coverage, and supplementary insurance status each demonstrated a statistically significant independent association with length of stay at the significance threshold of P < 0.05.

In contrast to these significant demographic and economic characteristics, other patient-level factors showed no statistically meaningful relationship with length of stay after multivariable adjustment. The regression model revealed that patient sex was not significantly associated with inpatient duration, yielding an adjusted p-value of P = 0.430. In addition, the number of previous hospitalizations recorded for an individual patient showed no statistically significant association with the duration of the hospital stay, producing an adjusted p-value of P = 0.793.

The specific hospital department where patients received care also functioned as a statistically significant independent predictor of inpatient length of stay within the negative binomial regression model (P < 0.05). Using the hospital’s endocrinology ward as the designated baseline reference group, the investigators found that lengths of stay were significantly longer among patients admitted to the internal medicine ward, the special care ward, and the psychiatry ward. By contrast, patients admitted to the general surgery ward, the obstetrics and gynecology ward, and the emergency ward experienced significantly shorter hospitalization durations than patients treated in the endocrinology reference ward.

Clinical diagnostic categories were likewise identified as statistically significant independent predictors of inpatient stay length in the multivariable model (P < 0.05). When compared against the baseline reference category of injuries, poisoning, and other consequences of external causes, the length of stay was significantly longer for patients admitted with neoplasms, conditions associated with pregnancy and childbirth, and infectious and parasitic diseases. Conversely, patients diagnosed with diseases of the circulatory system and those classified in the other diagnostic category experienced significantly shorter hospital stays compared to the reference group admitted for injuries, poisoning, and external consequences.

Reflecting on the practical applications of the research, the authors concluded that hospital length of stay data provide meaningful evidence to guide institutional bed management and healthcare resource allocation. Nevertheless, the researchers emphasized that although the facility’s observed average stay of 5.13 days was higher than the general national benchmark of 4 days, this comparison warrants caution because the analysis did not apply case-mix adjustments across patient conditions.

Subject of Research: Hospital length of stay and associated factors among tertiary care inpatients in Golestan, Iran

Article Title: Length of stay and its associated factors among hospitalized patients: a retrospective study using routinely collected Hospital Information System data in a tertiary care setting in Golestan, Iran

Article References: Heidari, A., Khatirnamani, Z., Dehghan, S., Badakhshan, A., Emiri, M., Majd, A. S., & Zanganeh, M. (2026). Length of stay and its associated factors among hospitalized patients: a retrospective study using routinely collected Hospital Information System data in a tertiary care setting in Golestan, Iran. BMC Health Services Research. https://doi.org/10.1186/s12913-026-16137-y

Image Credits: AI Generated

DOI: 10.1186/s12913-026-16137-y

Keywords: length of stay, hospital information system, tertiary healthcare, Shahid Sayyad Shirazi Hospital, Gorgan, Golestan province, negative binomial regression, bed management, resource allocation, supplementary insurance, health insurance coverage, internal medicine ward, endocrinology ward, special care ward, psychiatry ward, general surgery ward, infectious and parasitic diseases, inpatient admissions