Examining the discharge practices of surgeons at a large medical center.

We investigate the discharge practices at a large medical center. Specifically, we look for indications that patients are being discharged sooner because of hospital bed-capacity constraints. Using survival analysis techniques, we find statistically significant evidence to indicate that surgeons adjust their discharge practices to accommodate the surgical schedule and number of available recovery beds. We find higher discharge rates on days when utilization is high. We also find an increased discharge rate on days when more surgeries are scheduled. Our findings suggest that discharge decisions are made with bed-capacity constraints in mind. We discuss possible explanations for this, as well as the medical and managerial implications of our findings.