Impact of Severity-Adjusted Workload on Health Status of Patients Discharge from an ICU

32 Pages Posted: 16 Aug 2015

See all articles by Song-Hee Kim

Song-Hee Kim

University of Southern California - Marshall school of Business

Edieal J. Pinker

Yale School of Management; Yale University School of Management

Joan Rimar

Yale University - Yale New Haven Hospital (YNHH)

Elizabeth H. Bradley

Yale University - School of Public Health

Date Written: August 14, 2015

Abstract

We examine whether workload has an impact on a direct measure of the health status of patients discharged from Intensive Care Units (ICUs). We use data collected from the medical ICU and the surgical ICU of a major teaching hospital and a relatively new measure of patient acuity called the Rothman Index (RI). The RI is frequently updated during a patient’s hospital stay, which enables us to track patients health status very close to the time of their ICU discharge. Leveraging the RI, we measure ICU workload in a novel way that takes into account not only the census but also patient acuity. To our knowledge, this is the first study to show that more acutely ill patients are discharged from an ICU when the severity-adjusted workload is high rather than low. Further, we find that higher severity-adjusted workload is associated with ICU discharge times that start earlier and end later, a shorter ICU length-of-stay (LOS), and an increased likelihood of discharge to a step-down unit. We also find that downstream unit census influences the effect of workload on health status at ICU discharge.

Keywords: empirical operations management; healthcare delivery; intensive care units; severity-adjusted workload; congestion

JEL Classification: I12

Suggested Citation

Kim, Song-Hee and Pinker, Edieal J. and Rimar, Joan and Bradley, Elizabeth H., Impact of Severity-Adjusted Workload on Health Status of Patients Discharge from an ICU (August 14, 2015). Available at SSRN: https://ssrn.com/abstract=2644600 or http://dx.doi.org/10.2139/ssrn.2644600

Song-Hee Kim

University of Southern California - Marshall school of Business ( email )

BRI 401, 3670 Trousdale Parkway
Los Angeles, CA 90089
United States

Edieal J. Pinker (Contact Author)

Yale School of Management ( email )

135 Prospect Street
P.O. Box 208200
New Haven, CT 06520-8200
United States
203-436-8867 (Phone)

HOME PAGE: http://https://som.yale.edu/faculty/edieal-j-pinker

Yale University School of Management ( email )

New Haven, CT 06520
United States
203-436-8867 (Phone)

Joan Rimar

Yale University - Yale New Haven Hospital (YNHH) ( email )

New Haven, CT 06520
United States

Elizabeth H. Bradley

Yale University - School of Public Health ( email )

PO Box 208034
60 College Street
New Haven, CT 06520-8034
United States
203-785-2937 (Phone)

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