The effect of funding policy on day of week admissions and discharges in hospitals: the cases of Austria and Canada.
This paper compares two different funding policies for inpatients, the case-based approach in Austria versus the global budgeting approach in Canada. It examines the impact of these funding policies on length of stay of inpatients as one key measure of health outcome. In our study, six major clinical categories for inpatients are selected in which the day of the week for admission is matched to the particular day of the week of discharge for each individual case. The strategic statistical analysis proves that funding policies have a significant impact on the expected length of stay of inpatients. For all six clinical categories, Austrian inpatients stayed longer in hospitals compared to Canadian inpatients. Moreover, inpatients were not admitted and discharged equally throughout the week. We also statistically prove for certain clinical categories that more inpatients are discharged on certain days such as Mondays or Fridays depending on the funding policy. Our study is unique in the literature and our conclusions indicate that, with the right incentives in place, the length of stay can be decreased and discharge anomalies can be eliminated, which ultimately leads to a decrease in healthcare expenditures and an increase in healthcare effectiveness.
Leonard
Kevin J
KJ
Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, 12 Queens Park Crescent West, Toronto, Ont., Canada M5S 1A8. k.leonard@utoronto.ca
Rauner
Marion S
MS
Schaffhauser-Linzatti
Michaela Maria
MM
Yap
Richard
R
D001317:Austria; D002017:Budgets; D002170:Canada; D004469:Economics, Hospital; D005380:Financing, Government; D006291:Health Policy; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D009313:National Health Programs / Q000191:economics*; D016134:Organizational Policy; D010343:Patient Admission / Q000191:economics*; D010351:Patient Discharge / Q000191:economics*; D013997:Time Factors