Should Hospitals Keep Their Patients Longer? The Role of Inpatient Care in Reducing Post-Discharge Mortality

Ann P. Bartel, Carri W. Chan and Song-Hee (Hailey) Kim

No 20499, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: The Centers for Medicare & Medicaid Services (CMS) and the National Quality Forum have endorsed 30-day mortality rates as important indicators of hospital quality. Concerns have been raised, however, as to whether post-discharge mortality rates are reasonable measures of hospital quality as they consider the frequency of an event that occurs after a patient is discharged and no longer under the watch and care of the hospital. Using a large dataset comprised of all hospital encounters of every Medicare patient from 2000 to 2011 and an instrumental variables methodology to address the potential endogeneity bias in hospital length-of-stay, we find evidence that 30-day mortality rates are appropriate measures of hospital quality. For patients with diagnoses of Pneumonia or Acute Myocardial Infarction, an additional day in the hospital could decrease 30-day mortality rates by up to 12.8%. Moreover, we find that, from a social planner's perspective, the gains achieved in reducing mortality rates far exceed the cost of keeping these patients in the hospital for an additional day.

JEL-codes: I10 I13 I18 L38 (search for similar items in EconPapers)
Date: 2014-09
New Economics Papers: this item is included in nep-hea and nep-ias
Note: EH PE
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Citations: View citations in EconPapers (5)

Published as Ann P. Bartel, Carri W. Chan, Song-Hee Kim (2019) "Should Hospitals Keep Their Patients Longer? The Role of Inpatient Care in Reducing Postdischarge Mortality." Management Science 66(6):2326-2346.

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