Short-term fluctuations in hospital demand: implications for admission, discharge, and discriminatory behavior.
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
Sharma
Rajiv
R
Portland State University, USA. sharmar@pdx.edu
Stano
Miron
M
Gehring
Renu
R
D003953:Diagnosis-Related Groups; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health; D007902:Length of Stay / Q000706:statistics & numerical data*; D008484:Medicaid; D009922:Oregon; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011287:Prejudice; D017149:Private Sector; D013269:Stochastic Processes; D014481:United States