An Empirical Study of the Effect of ICU Capacity Strain on Patient Discharge

34 Pages Posted: 16 Aug 2015 Last revised: 16 Oct 2020

See all articles by Song-Hee Kim

Song-Hee Kim

Seoul National University - Business School

Edieal J. Pinker

Yale School of Management; Yale University School of Management

Joan Rimar

affiliation not provided to SSRN

Date Written: October 15, 2020

Abstract

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

Kim, Song-Hee and Pinker, Edieal J. and Rimar, Joan, An Empirical Study of the Effect of ICU Capacity Strain on Patient Discharge (October 15, 2020). Available at SSRN: https://ssrn.com/abstract=2644600 or http://dx.doi.org/10.2139/ssrn.2644600

Song-Hee Kim

Seoul National University - Business School ( email )

Seoul
Korea, Republic of (South Korea)

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

affiliation not provided to SSRN

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