Hospital patients are discharged earlier on busier days

Portland, OR – September 24, 2008 – When a hospital is capacity constrained, the constraint can affect admission and discharge decisions. A new study in the RAND Journal of Economics 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."

This study is published in the Summer 2008 issue of the RAND Journal of Economics. Media wishing to receive a PDF of this article may contact journalnews@bos.blackwellpublishing.net.

Rajiv Sharma is affiliated with Portland State University and can be reached for questions at sharmar@pdx.edu.

The RAND Journal of Economics publishes theoretical and empirical research on industrial organization and closely related topics, including contracts, organizations, law and economics, and regulation.

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