R.H. Smith School of Business, University of Maryland, College Park, MD 20742, USA.
Health Care Manag Sci. 2011 Dec;14(4):338-47. doi: 10.1007/s10729-011-9167-6. Epub 2011 Jun 15.
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.
我们调查了一家大型医疗中心的出院实践。具体来说，我们寻找患者因医院床位容量限制而提前出院的迹象。使用生存分析技术，我们发现有统计学意义的证据表明，外科医生调整他们的出院实践以适应手术计划和可用恢复床位的数量。我们发现利用率高的日子出院率更高。我们还发现，当计划进行更多手术时，出院率也会增加。我们的研究结果表明，出院决策是考虑到床位容量限制做出的。我们讨论了对此的可能解释，以及我们研究结果对医疗和管理的影响。
