title: Examining the discharge practices of surgeons at a large medical center.
abstract: 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.
authors.affiliation: R.H. Smith School of Business, University of Maryland, College Park, MD 20742, USA.
authors.forename: David
authors.initials: D
authors.lastname: Anderson
authors.forename: Carter
authors.initials: C
authors.lastname: Price
authors.forename: Bruce
authors.initials: B
authors.lastname: Golden
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jank
authors.forename: Edward
authors.initials: E
authors.lastname: Wasil
mesh_terms: D001071:Appointments and Schedules; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014481:United States