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Analysis of hospital length of stay and discharge destination using hazard functions with unmeasured heterogeneity

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Author Info
Gabriel Picone (University of South Florida, Tampa, Florida, USA)
R. Mark Wilson (University of South Florida, Tampa, Florida, USA)
Shin-Yi Chou (New Jersey Institute of Technology, USA)
Abstract

The hospital length-of-stay and the discharge destination of a Medicare patient are the outcomes of one decision process involving the interests of the patient, the hospital, and the firms offering covered post-hospital care. We use a competing risk hazard estimation procedure and adjust for unobserved heterogeneity with a non-parametric technique to identify significant factors in the decision process. A patient's health and socio-economic characteristics, the availability of informal care, local market area conditions, and Medicare policies influence length-of-stay and discharge destination. The substitution we find between hospital and post-hospital care and among post-hospital care alternatives has policy implications for Medicare. Copyright © 2003 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.800
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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 12 (2003)
Issue (Month): 12 ()
Pages: 1021-1034
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Handle: RePEc:wly:hlthec:v:12:y:2003:i:12:p:1021-1034

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

  1. Heckman, James & Singer, Burton, 1984. "A Method for Minimizing the Impact of Distributional Assumptions in Econometric Models for Duration Data," Econometrica, Econometric Society, vol. 52(2), pages 271-320, March. [Downloadable!] (restricted)
  2. Newhouse, Joseph P. & Byrne, Daniel J., 1988. "Did Medicare's Prospective Payment System cause length of stay to fall?," Journal of Health Economics, Elsevier, vol. 7(4), pages 413-416, December. [Downloadable!] (restricted)
  3. Butler, J S & Anderson, Kathryn H & Burkhauser, Richard V, 1989. "Work and Health after Retirement: A Competing Risks Model with Semiparametric Unobserved Heterogeneity," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 46-53, February. [Downloadable!] (restricted)
  4. Van den Berg, G J & Lindeboom, M & Ridder, G, 1994. "Attrition in Longitudinal Panel Data and the Empirical Analysis of Dynamic Labour Market Behaviour," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 9(4), pages 421-35, Oct.-Dec.. [Downloadable!] (restricted)
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  5. Martin, Stephen & Smith, Peter, 1996. "Explaining variations in inpatient length of stay in the National Health Service," Journal of Health Economics, Elsevier, vol. 15(3), pages 279-304, June. [Downloadable!] (restricted)
  6. Hamilton, Barton H. & Hamilton, Vivian H. & Mayo, Nancy E., 1996. "What are the costs of queuing for hip fracture surgery in Canada?," Journal of Health Economics, Elsevier, vol. 15(2), pages 161-185, April. [Downloadable!] (restricted)
  7. Ellis, Randall P. & Ruhm, Christopher J., 1988. "Incentives to transfer patients under alternative reimbursement mechanisms," Journal of Public Economics, Elsevier, vol. 37(3), pages 381-394, December. [Downloadable!] (restricted)
  8. Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, vol. 63(1), pages 29-50, January. [Downloadable!] (restricted)
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  9. David M. Cutler & Ellen Meara, 1999. "The Concentration of Medical Spending: An Update," NBER Working Papers 7279, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  10. Frank A. Sloan & Gabriel A. Picone & Donald H. Taylor, Jr. & Shin-Yi Chou, 1999. "Does Where You Are Admitted Make a Difference? An Analysis of Medicare Data," NBER Working Papers 6896, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Emi Sato & Kiyohide Fushimi, 2009. "What has influenced patient health-care expenditures in Japan?: variables of age, death, length of stay, and medical care," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 843-853. [Downloadable!]
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