Demand, selection and patient outcomes in German acute care hospitals
Article first published online: 4 FEB 2011
Copyright © 2011 John Wiley & Sons, Ltd.
Volume 21, Issue 3, pages 209–221, March 2012
How to Cite
Schwierz, C., Augurzky, B., Focke, A. and Wasem, J. (2012), Demand, selection and patient outcomes in German acute care hospitals. Health Econ., 21: 209–221. doi: 10.1002/hec.1706
- Issue published online: 23 JAN 2012
- Article first published online: 4 FEB 2011
- Manuscript Accepted: 9 NOV 2010
- Manuscript Revised: 16 AUG 2010
- Manuscript Received: 10 DEC 2008
- hospital staffing;
- inpatient outcomes
This paper examines the effects of variation in unexpected demand on patient outcomes in acute care German hospitals. Naturally, an unexpected surge in demand may negatively affect the quality of care and thus patient outcomes, such as in-hospital mortality. We estimate models explaining patient outcomes depending on demand, unobservable patient selection and seasonal factors, as well as patient-specific risk factors and unobservable hospital and department fixed-effects. The main message of this analysis is that hospitals are well prepared to deal with this unexpected volatility in demand, as by and large it does not negatively affect patient outcomes. Hospitals seem to deal with high unexpected workload by steering the patients' length of stay relating to their severity of illness. Elective patients are discharged earlier, while discharges of high-risk emergency patients are postponed. Copyright © 2011 John Wiley & Sons, Ltd.