An Empirical Study of the Effect of ICU Capacity Strain on Patient Discharge
34 Pages Posted: 16 Aug 2015 Last revised: 16 Oct 2020
Date Written: October 15, 2020
Intensive Care Units (ICUs) play a vital role in hospitals and they often have capacity strain. Using data from a major teaching hospital, we empirically examine the effect of ICU capacity strain on patient discharge. Our data has a dynamic measure of patient health status, allowing us to study the effect with two novel approaches. First, we account for patient acuity in capacity strain measurement whereas prior research generally accounted for census only. Second, we examine the relationship between capacity strain and patient health status at discharge instead of longer-term outcomes. We find that 1) number of daily discharges increases in census and decreases in percentage of acute patients and that the effect of census is bigger when percentage of acute patients is lower; 2) discharged patients’ health status does not depend on census. Given equal census, sicker patients are discharged when percentage of acute patients is higher, which we show to be the result of sampling bias; and 3) ICU capacity strain does not affect discharged patients' individual patient outcome. In sum, contradicting prior literature, we do not find evidence for aggressive premature ICU discharge behavior in our study ICU. This difference likely comes from our sophisticated measure of ICU capacity strain and our direct measure of patient outcome at ICU discharge. Our findings suggest that ICUs need to track changes in patient acuity in addition to census to measure capacity strain and that future studies of ICU should take patient acuity into account in ICU capacity strain measures.
Keywords: empirical operations management; healthcare delivery; intensive care units; capacity strain; discharge; patient outcome
JEL Classification: I12
Suggested Citation: Suggested Citation