When a hospital is capacity constrained, the constraint can affect admission and discharge decisions. A new study examined how hospitals' admission and discharge behavior is affected by fluctuations in demand.
Results show that on days when hospitals face high demand, patients are discharged earlier than expected when compared to those discharged on days when demand is low.
Rajiv Sharma, Miron Stano, and Renu Gehring used Oregon hospital data to analyze how hospital constraint can affect admission decisions and discharge decisions. Researchers used around 380,000 records comprising inpatient discharges.
Results showing that patients are dismissed earlier on days when hospitals face high demand were found using methods that are designed to detect discriminatory behavior without the need to control for differences across patient groups in their health status or care seeking behavior. The study did not find evidence of discriminatory discharge behavior.
"The need to reduce disparities in health and health care has emerged as a key policy priority," the authors note. "We show that it is possible to detect discriminatory behavior by hospitals by using widely available administrative data."
- Sharma et al. Short-term fluctuations in hospital demand: implications for admission, discharge, and discriminatory behavior. The RAND Journal of Economics, 2008; 39 (2): 586 DOI: 10.1111/j.0741-6261.2008.00029.x
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