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Demand, selection and patient outcomes in German acute care hospitals

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  • Christoph Schwierz
  • Boris Augurzky
  • Axel Focke
  • Jürgen Wasem

Abstract

This paper examines the effects of variation in unexpected demand on patient outcomes in acute care German hospitals. Naturally, an unexpected surge in demand may negatively affect the quality of care and thus patient outcomes, such as in‐hospital mortality. We estimate models explaining patient outcomes depending on demand, unobservable patient selection and seasonal factors, as well as patient‐specific risk factors and unobservable hospital and department fixed‐effects. The main message of this analysis is that hospitals are well prepared to deal with this unexpected volatility in demand, as by and large it does not negatively affect patient outcomes. Hospitals seem to deal with high unexpected workload by steering the patients' length of stay relating to their severity of illness. Elective patients are discharged earlier, while discharges of high‐risk emergency patients are postponed. Copyright © 2011 John Wiley & Sons, Ltd.

Suggested Citation

  • Christoph Schwierz & Boris Augurzky & Axel Focke & Jürgen Wasem, 2012. "Demand, selection and patient outcomes in German acute care hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 209-221, March.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:3:p:209-221
    DOI: 10.1002/hec.1706
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    References listed on IDEAS

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    1. David M. Cutler & Robert S. Huckman & Mary Beth Landrum, 2004. "The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery," American Economic Review, American Economic Association, vol. 94(2), pages 342-346, May.
    2. Schwierz, Christoph & Augurzky, Boris & Wasem, Jürgen, 2009. "Does the Quality of Hospital Treatment Vary by Days of the Week?," Ruhr Economic Papers 105, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
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    4. Evans, William N. & Kim, Beomsoo, 2006. "Patient outcomes when hospitals experience a surge in admissions," Journal of Health Economics, Elsevier, vol. 25(2), pages 365-388, March.
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    Cited by:

    1. Nan Jiang & Gail Pacheco, 2014. "Demand in New Zealand hospitals: expect the unexpected?," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4475-4489, December.
    2. Bhalotra, Sonia R. & Nunes, Letícia & Rocha, Rudi, 2020. "Urgent Care Centers, Hospital Performance and Population Health," IZA Discussion Papers 13992, Institute of Labor Economics (IZA).
    3. Emilio Gutierrez & Adrian Rubli, 2021. "Shocks to Hospital Occupancy and Mortality: Evidence from the 2009 H1N1 Pandemic," Management Science, INFORMS, vol. 67(9), pages 5943-5952, September.
    4. Bhalotra, Sonia & Nunes, Letícia & Rocha, Rudi, 2023. "Emergency Care Centers, Hospital Performance and Population Health," CAGE Online Working Paper Series 659, Competitive Advantage in the Global Economy (CAGE).
    5. Jonas Krämer & Jonas Schreyögg & Reinhard Busse, 2019. "Classification of hospital admissions into emergency and elective care: a machine learning approach," Health Care Management Science, Springer, vol. 22(1), pages 85-105, March.

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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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