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

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  • 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.

Suggested Citation

  • Gabriel Picone & R. Mark Wilson & Shin-Yi Chou, 2003. "Analysis of hospital length of stay and discharge destination using hazard functions with unmeasured heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1021-1034.
  • Handle: RePEc:wly:hlthec:v:12:y:2003:i:12:p:1021-1034
    DOI: 10.1002/hec.800
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    References listed on IDEAS

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    Cited by:

    1. Échevin, Damien & Fortin, Bernard, 2014. "Physician payment mechanisms, hospital length of stay and risk of readmission: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 36(C), pages 112-124.
    2. Joan Costa-Font & Sergi Jiménez-Martín & Cristina Villaplana, 2016. "Does Long-Term Care Subsidisation Reduce Unnecessary Hospitalisations?," Working Papers 2016-05, FEDEA.
    3. Perelman, Julian & Shmueli, Amir & Closon, Marie-Christine, 2008. "Deriving a risk-adjustment formula for hospital financing: Integrating the impact of socio-economic status on length of stay," Social Science & Medicine, Elsevier, vol. 66(1), pages 88-98, January.
    4. W. David Bradford & Andrew N. Kleit & Paul J. Nietert & Steven Ornstein, 2010. "The Effect Of Direct To Consumer Television Advertising On The Timing Of Treatment," Economic Inquiry, Western Economic Association International, vol. 48(2), pages 306-322, April.
    5. Fernandez, Jose-Luis & McGuire, Alistair & Raikou, Maria, 2018. "Hospital coordination and integration with social care in England: The effect on post-operative length of stay," Journal of Health Economics, Elsevier, vol. 61(C), pages 233-243.
    6. Joan Costa-i-Font & Sergi Jimenez-Martin & Cristina Vilaplana, 2016. "Does Long-Term Care Subsidisation Reduce Hospital Admissions?," CESifo Working Paper Series 6078, CESifo Group Munich.
    7. Damien Échevin & Bernard Fortin, 2011. "Physician Payment Mechanisms, Hospital Length of Stay and Risk of Readmission: a Natural Experiment," CIRANO Working Papers 2011s-44, CIRANO.
    8. Costa-Font, Joan & Jimenez-Martin, Sergi & Vilaplana, Cristina, 2018. "Does long-term care subsidization reduce hospital admissions and utilization?," Journal of Health Economics, Elsevier, vol. 58(C), pages 43-66.
    9. Sylvia Brandt & Peter Marie, 2011. "Racial Disparities in Hospital Length of Stay for Asthma: Implications for Economic Policies," Journal of Family and Economic Issues, Springer, vol. 32(1), pages 152-169, March.
    10. 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.
    11. Siciliani Luigi, 2013. "The Economics of Long-Term Care," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 343-375, August.
    12. James Gaughan & Hugh Gravelle & Luigi Siciliani, 2014. "Testing the bed-blocking hypothesis: does higher supply of nursing and care homes reduce delayed hospital discharges?," Working Papers 102cherp, Centre for Health Economics, University of York.
    13. James Gaughan & Hugh Gravelle & Rita Santos & Luigi Siciliani, 2013. "Long term care provision, hospital length of stay and discharge destination for hip fracture and stroke patients," Working Papers 086cherp, Centre for Health Economics, University of York.
    14. James Gaughan & Hugh Gravelle & Rita Santos & Luigi Siciliani, 2017. "Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 311-331, September.
    15. Yan Meng & Xueyan Zhao & Xibin Zhang & Jiti Gao, 2017. "A panel data analysis of hospital variations in length of stay for hip replacements: Private versus public," Monash Econometrics and Business Statistics Working Papers 20/17, Monash University, Department of Econometrics and Business Statistics.
    16. Helmut Herwartz & Christoph Strumann, 2012. "On the effect of prospective payment on local hospital competition in Germany," Health Care Management Science, Springer, vol. 15(1), pages 48-62, March.
    17. Raul Razo-Garcia, 2011. "The Duration of Intermediate Exchange Rate Regimes and Capital Controls," Carleton Economic Papers 11-01, Carleton University, Department of Economics, revised 17 Oct 2011.

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