Short-term fluctuations in hospital demand: implications for admission, discharge, and discriminatory behavior

• 成果类型: Article
• 署名作者: Sharma, Rajiv; Stano, Miron; Gehring, Renu
• 署名单位: Portland State University; Oakland University
• 刊物名称: RAND JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0741-6261
• DOI: 10.1111/j.0741-6261.2008.00029.x
• 发表日期: 2008
• 页码: 586-606
• 关键词: statistical discrimination; bed; COSTS; MODEL; care

摘要

We analyze admission and discharge decisions when hospitals become capacity constrained on high-demand days, and develop a test for discrimination that, under certain circumstances, does not require controls for differences across patient groups. On high-demand days, patients are discharged earlier than expected compared to those discharged on low-demand days. High demand creates no statistically significant differences in hospitals' admission behavior. Thus, hospitals appear to ration capacity by hastening discharges rather than by restricting admissions. We could not reject a null hypothesis of no discrimination against Medicaid patients in discharges.