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The relationship between workload and length of stay in Singapore

Author

Listed:
  • Zhou, Ke
  • Vidyarthi, Arpana
  • Matchar, David
  • Cheung, Yin Bun
  • Lam, Shao Wei
  • Ong, Marcus

Abstract

Prior studies link higher workload with longer length of stay (LOS) in the US. Unlike U.S. hospitals, Singaporean hospitals, like other major hospitals in the Asia-Pacific, are partially occupied by patients with non-acute needs due to insufficient alternative facilities. We examined the association between workload and length of stay (LOS) and the impact of workload on 30-day re-hospitalization and inpatient mortality rates in retrospective cohort in this setting. We defined workload as the daily number of patients per physician team. 13,097 hospitalizations of 10,000 patients were included. We found that higher workload was associated with shorter LOS (coefficient, −0.044 [95%CI, −0.083, −0.01]), especially for patients with longer stays (hazard ratios, not significantly greater than 1 before Day 4, 1.04 [95%CI, 1.01, 1.07] at Day 4 and 1.16 [95%CI, 1.10, 1.24] at Day 10), without affecting inpatient mortality (odds ratio (OR), 1.03 [95%CI, 0.99, 1.05]) or 30-day re-hospitalization (OR, 1.01 [95%CI, 0.99, 1.04]). This result differs from studies in the US and may reflect regional differences in the use of acute hospital beds for non-acute needs.

Suggested Citation

  • Zhou, Ke & Vidyarthi, Arpana & Matchar, David & Cheung, Yin Bun & Lam, Shao Wei & Ong, Marcus, 2018. "The relationship between workload and length of stay in Singapore," Health Policy, Elsevier, vol. 122(7), pages 769-774.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:7:p:769-774
    DOI: 10.1016/j.healthpol.2018.04.002
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    References listed on IDEAS

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    1. Tom Fangyun Tan & Serguei Netessine, 2014. "When Does the Devil Make Work? An Empirical Study of the Impact of Workload on Worker Productivity," Management Science, INFORMS, vol. 60(6), pages 1574-1593, June.
    2. Motohashi, Takako & Hamada, Hironori & Lee, Jason & Sekimoto, Miho & Imanaka, Yuichi, 2013. "Factors associated with prolonged length of hospital stay of elderly patients in acute care hospitals in Japan: A multilevel analysis of patients with femoral neck fracture," Health Policy, Elsevier, vol. 111(1), pages 60-67.
    3. David C. Chan, 2016. "Teamwork and Moral Hazard: Evidence from the Emergency Department," Journal of Political Economy, University of Chicago Press, vol. 124(3), pages 734-770.
    4. World Bank, 2016. "Live Long and Prosper," World Bank Publications - Books, The World Bank Group, number 23133, December.
    5. Paul L Delamater & Joseph P Messina & Sue C Grady & Vince WinklerPrins & Ashton M Shortridge, 2013. "Do More Hospital Beds Lead to Higher Hospitalization Rates? A Spatial Examination of Roemer’s Law," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-16, February.
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