{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T01:02:43Z","timestamp":1773104563757,"version":"3.50.1"},"reference-count":30,"publisher":"CSIRO Publishing","issue":"6","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,4]]},"abstract":"<jats:p>There are wide variations in acute care inpatient lengths of stay. Until now, analysing these variations included patient, clinical and system factors, leaving 40\u201380% of the variation still unexplained. Chronic breathlessness has been ignored by health systems: the first international consensus definition was only proposed in 2017, and the first International Classification of Disease (ICD) code for it was accepted in 2022. (Until 2022, the health system through ICD only recognised \u2018acute breathlessness\u2019 and \u2018orthopnoea\u2019 (the inability to lie flat without breathlessness).) Studies of the general population (independent of health service contact) have shown that at least 1 in 300 Australians are housebound or have difficulty dressing and undressing because of chronic breathlessness. The symptom affects every part of a person\u2019s life and contributes to unplanned use of primary and tertiary healthcare. Rather than focusing only on diseases in understanding variations in length of stay, the addition of chronic symptoms is of value. In recent work, pre-existing breathlessness (captured in general practice) predicts a shorter time to people\u2019s next unplanned hospital admission and longer hospital admissions for every increased level of chronic breathlessness severity, having controlled for other factors. ICD v11.0 now has a code 'chronic breathlessness' that we should be using. Research is needed on why people with chronic breathlessness have increased use of emergency departments and longer lengths of stay. Clinicians need to actively identify the presence of chronic breathlessness, and health systems need to research how to minimise its impacts.<\/jats:p>","DOI":"10.1071\/ah25253","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:34:37Z","timestamp":1763944477000},"source":"Crossref","is-referenced-by-count":1,"title":["Chronic breathlessness is associated with much longer lengths of hospital stay"],"prefix":"10.1071","volume":"49","author":[{"given":"David","family":"Currow","sequence":"first","affiliation":[{"name":"ACollege of Medicine and Public Health, Flinders University, SA, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3531-0389","authenticated-orcid":true,"given":"Slavica","family":"Kochovska","sequence":"additional","affiliation":[{"name":"ACollege of Medicine and Public Health, Flinders University, SA, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael","family":"Evans","sequence":"additional","affiliation":[{"name":"BDepartment of Respiratory Sciences, University of Leicester, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janelle","family":"Yorke","sequence":"additional","affiliation":[{"name":"CSchool of Nursing, The Hong Kong Polytechnic University, Hong Kong."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia M.","family":"Davidson","sequence":"additional","affiliation":[{"name":"DFaculty of Medicine and Health, University of New South Wales, NSW, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"issue":"2","key":"2025121504451641600_R1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1071\/ah010063","article-title":"Factors influencing patients\u2019 length of stay.","volume":"24","author":"Liu","year":"2001","journal-title":"Aust Health Rev"},{"key":"2025121504451641600_R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.health.2022.100123","article-title":"A comprehensive analysis of temporal trends of between-hospital variation in mortality, readmission and length of stay using logistic regression.","volume":"2","author":"Van Wilder","year":"2022","journal-title":"Healthcare Anal"},{"issue":"3","key":"2025121504451641600_R3","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1108\/JHOM-10-2017-0275","article-title":"Variables affecting hospital length of stay: a scoping review.","volume":"32","author":"Buttigieg","year":"2018","journal-title":"J Health Organ Manag"},{"issue":"2","key":"2025121504451641600_R4","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1097\/TA.0000000000002279","article-title":"Most of the variation in length of stay in emergency general surgery is not related to clinical factors of patient care.","volume":"87","author":"Achanta","year":"2019","journal-title":"J Trauma Acute Care Surg"},{"issue":"6","key":"2025121504451641600_R5","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1089\/jpm.2014.0444","article-title":"The population burden of chronic symptoms that substantially predate the diagnosis of a life-limiting illness.","volume":"18","author":"Currow","year":"2015","journal-title":"J Palliat Med"},{"issue":"5","key":"2025121504451641600_R6","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02277-2016","article-title":"Towards an expert consensus to delineate a clinical syndrome of chronic breathlessness.","volume":"49","author":"Johnson","year":"2017","journal-title":"Eur Resp J"},{"key":"2025121504451641600_R7","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0104-2025","article-title":"Prevalence and correlates of breathlessness in adults: an umbrella review and updated systematic review with meta-analysis in general and clinical populations.","volume":"34","author":"Cheng","year":"2025","journal-title":"Eur Resp Rev"},{"issue":"4","key":"2025121504451641600_R8","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.jpainsymman.2009.01.006","article-title":"A community population survey of prevalence and severity of dyspnea in adults.","volume":"38","author":"Currow","year":"2009","journal-title":"J Pain Symptom Manage"},{"issue":"7","key":"2025121504451641600_R9","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1089\/jpm.2011.0430","article-title":"To what causes do people attribute their chronic breathlessness? 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