OPEN Health, Rotterdam, The Netherlands.
J Health Econ. 2022 Jul;84:102640. doi: 10.1016/j.jhealeco.2022.102640. Epub 2022 May 26.
Excessive length of hospital stay is among the leading sources of inefficiency in healthcare. When a patient is clinically fit to be discharged but requires support outside the hospital, which is not readily available, they remain hospitalized until a safe discharge is possible -a phenomenon called bed-blocking. I study whether the availability of subsidized nursing homes and home care teams reduces hospital bed-blocking. Using individual data on the universe of inpatient admissions at Portuguese hospitals during 2000-2015, I find that the entry of home care teams in a region reduces bed-blocking by 4 days per episode, on average. Nursing home entry only reduces bed-blocking among patients with high care needs or when the intensity of entry is high. Reductions in bed-blocking do not harm patients' health. The beds freed up by reducing bed-blocking are used to admit additional elective patients.
住院时间过长是医疗保健效率低下的主要原因之一。当患者在临床上适合出院但需要医院以外的支持，而这些支持无法立即提供时，他们会继续住院，直到可以安全出院——这种现象称为床位占用。我研究了补贴养老院和家庭护理团队的可用性是否会减少医院床位占用。利用 2000 年至 2015 年葡萄牙医院住院患者的个人数据，我发现家庭护理团队在一个地区的进入平均每例减少了 4 天的床位占用。养老院入住仅在高护理需求的患者或入住强度高的情况下减少床位占用。减少床位占用不会损害患者的健康。通过减少床位占用腾出的床位用于收治更多的择期患者。
