Do Hospital Length of Stay and Staffing Ratio Affect Elderly Patients' Risk of Readmission? A Nation‐wide Study of Norwegian Hospitals

Heggestad, Torhild

doi:10.1111/1475-6773.00042

Cited by 94 publications

(91 citation statements)

References 27 publications

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“…In one study, short LOS was associated with an increased risk of readmission, 8 and in another it was linked to an increased risk of mortality in patients admitted with acute pulmonary embolism. 6 Other studies, however, failed to find harm associated with short LOS in patients admitted for acute myocardial infarction 9 or coronary artery bypass graft surgery (CABG), 10 and in Medicare recipients.…”

Section: Introductionmentioning

confidence: 97%

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Increased Risk of Mortality among Patients Cared for by Physicians with Short Length-of-Stay Tendencies

Southern

Arnsten

2015

J GEN INTERN MED

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Section: Introductionmentioning

confidence: 97%

“…5,6,[8][9][10] In particular, because LOS is closely associated with disease severity, patients with shorter LOS are, on average, less severely ill than patients with longer hospitalizations. Observational studies comparing outcomes between the two groups are thus biased toward finding better outcomes for short LOS patients.…”

Section: Introductionmentioning

confidence: 99%

Increased Risk of Mortality among Patients Cared for by Physicians with Short Length-of-Stay Tendencies

Southern

Arnsten

2015

J GEN INTERN MED

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“…Are these outcomes influenced by unexpected demand and consequently insufficient quality hospital care? For instance, previous work by Heggestad (2002) for Norway finds a positive association between average length of stay and staffing ratio, with respect to elderly patients' (at least 67 years or age) risk of readmission. In the next section we focus on predicting demand at both the aggregate country level in NZ, as well as regional sub-groups based on specific DHBs, to ascertain whether hospitals have access to enough information to be able to accurately predict expected demand levels.…”

Section: Following Evans and Kimmentioning

confidence: 98%

Demand in New Zealand hospitals: expect the unexpected?

Jiang

Pacheco

2014

Applied Economics

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The health care sector in New Zealand has undergone substantial structural reform since 1983, and stands out relative to other OECD countries, in that it has a relatively low per capita health expenditure, and a high share of public funding. Efficient allocation of resources to accommodate local needs in this community-oriented and public dominant model of the health care system is paramount. This paper employs the National Minimum Dataset from 2007 to 2011 to construct an empirical model aimed at predicting hospital demand. We formulate an easy to implement approach that can be used at the national level, as well as for individual District Health Boards (DHBs) that are regionally defined, and can also be disaggregated by category of patient, e.g. acute care versus elective admissions. We find the use of lagged information in this model to be vital, and by contrasting expected and actual demand, we then evaluate variations in excess demand. We find evidence that suggests in low risk elective cases, unexpected demand significantly reduces an individual's hospital stay, and increases the likelihood of acute readmission in 30 days. Additionally, the cumulative evidence presented points to excess demand at both the hospital level and within-disease chapter, resulting in more attention paid to high risk patients, to the detriment of low risk cases. The negatively and significant association between hospital stay and readmission in 30 days for low risk cases may prompt policy makers to consider a 'reduction in readmission program' for New Zealand.

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“…Using data from a paediatric intensive care unit Arias et al (2004) detect no association between the day of admission and mortality rates, but a positive association between evening admissions and mortality rates. Heggestad (2002) finds that admission to a hospital with a relatively short average LOS increases the rate of unplanned readmission and that more staff has a compensatory effect on this adverse outcome.…”

Section: Introductionmentioning

confidence: 99%

Does the Quality of Hospital Treatment Vary by Days of the Week?

Augurzky

Schwierz

2006

SSRN Journal

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Abstract This paper investigates the relationship between health outcomes and variations in staffing levels as approximated by admissions on weekdays versus admissions on weekends. Because days of admission are potentially endogenous, we instrument on emergency admissions only, which are reasonably exogenous to the time of admission. Further, we introduce a direct measure for within-diagnosis variation in severity across days of admission to control for the unobservable selection of patients. We find that after controlling for patient heterogeneity and endogeneity of the day of admission there is still a significant variation in mortality rates between weekend and weekday admissions. Patients admitted during the weekend exhibit higher in-hospital mortality rates. We also find signs of premature discharge, as patients with short lengths of stay tend to exhibit higher probability to be readmitted as emergency cases. Terms of use: Documents inJEL Classification: I12, I18

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Do Hospital Length of Stay and Staffing Ratio Affect Elderly Patients' Risk of Readmission? A Nation‐wide Study of Norwegian Hospitals

Abstract: The results give support to the assumption of a link between hospital operating conditions and patient outcome.

Cited by 94 publications

References 27 publications

Increased Risk of Mortality among Patients Cared for by Physicians with Short Length-of-Stay Tendencies

Increased Risk of Mortality among Patients Cared for by Physicians with Short Length-of-Stay Tendencies

Demand in New Zealand hospitals: expect the unexpected?

Does the Quality of Hospital Treatment Vary by Days of the Week?

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