Does the Quality of Hospital Treatment Vary by Days of the Week?
Does the Quality of Hospital Treatment Vary by Days of the Week?
复制标题
医院治疗的质量是否因一周中的几天而异？
DOI：
--
复制
发表时间：
2009
期刊：
影响因子：
--
通讯作者：
J. Wasem
中科院分区：
文献类型：
--
作者：
C. Schwierz;B. Augurzky;J. Wasem
本文调查了健康结果和人员配置水平的变化之间的关系，近似由平日与周末入院。由于入院天数可能是内源性的，因此我们仅对急诊入院进行分析，这对入院时间来说是合理的外源性。此外，我们引入了一个直接的措施，诊断内的严重程度的变化，在入院的日子，以控制不可观察的选择patient.We发现，在控制病人的异质性和endoviration入院的日子，仍然有一个显着的变化，死亡率之间的周末和平日的入院。周末入院的患者显示出更高的住院死亡率。我们还发现了提前出院的迹象，因为住院时间短的患者往往表现出更高的急诊再入院概率。
This paper investigates the relationship between health outcomes and variations in staffing levels as approximated by admissions on weekdays versus admissions on weekends. Because days of admission are potentially endogenous, we instrument on emergency admissions only, which are reasonably exogenous to the time of admission. Further, we introduce a direct measure for within-diagnosis variation in severity across days of admission to control for the unobservable selection of patients.We find that after controlling for patient heterogeneity and endogeneity of the day of admission there is still a significant variation in mortality rates between weekend and weekday admissions. Patients admitted during the weekend exhibit higher in-hospital mortality rates. We also find signs of premature discharge, as patients with short lengths of stay tend to exhibit higher probability to be readmitted as emergency cases.