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Hospital Crowding and Patient Outcomes

Author

Listed:
  • Wolfgang Frimmel
  • Felix Glaser
  • Gerald J. Pruckner

Abstract

Using high-quality administrative data from Upper Austria, we analyze the effect of hospital crowding on patients' short- and medium-term healthcare utilization and labor market outcomes. Focusing on acute inpatient diagnoses, we exploit idiosyncratic variation in daily diagnosis-related hospital occupancy rates to estimate the causal effect of hospital crowding. We find that higher crowding levels reduce hospital care intensity, as reflected in fewer medical services provided, lower hospital expenditures, and earlier discharges. Despite these changes, quality of care indicators, including readmissions and mortality, remain unaffected. However, no significant effects are observed either on inpatient and outpatient healthcare utilization in the short- and medium-term or on patients' labor market outcomes following initial hospitalization. These results suggest that crowding-induced differences in hospital care do not lead to changes in patients' health or economic situations over the medium term.

Suggested Citation

  • Wolfgang Frimmel & Felix Glaser & Gerald J. Pruckner, 2025. "Hospital Crowding and Patient Outcomes," Economics working papers 2025-01, Department of Economics, Johannes Kepler University Linz, Austria.
  • Handle: RePEc:jku:econwp:2025-01
    Note: English
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    References listed on IDEAS

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    1. Francetic, I.; & Meacock, R.; & Siciliani, L.; & Sutton, M.;, 2024. "Disorderly queues: How does unexpected demand affect queue prioritisation in emergency care?," Health, Econometrics and Data Group (HEDG) Working Papers 24/14, HEDG, c/o Department of Economics, University of York.
    2. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2020. "Capacity constraints and time allocation in public health clinics," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 324-336, March.
    3. Bruno Martins & Luís Filipe, 2020. "Doctors' response to queues: Evidence from a Portuguese emergency department," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 123-137, February.
    4. 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.
    5. 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.
    6. 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.
    7. Alison Andrew & Marcos Vera-Hernández, 2024. "Incentivizing Demand for Supply-Constrained Care: Institutional Birth in India," The Review of Economics and Statistics, MIT Press, vol. 106(1), pages 102-118, January.
    8. Raja, Chandni, 2023. "How do hospitals respond to input regulation? Evidence from the California nurse staffing mandate," Journal of Health Economics, Elsevier, vol. 92(C).
    9. Eduardo Costa, 2022. "The unintended consequences of hospital strikes on patient outcomes evidence from multiple strikes in the Portuguese National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2499-2511, November.
    10. Daniel Avdic & Petter Lundborg & Johan Vikström, 2024. "Does Health Care Consolidation Harm Patients? Evidence from Maternity Ward Closures," American Economic Journal: Economic Policy, American Economic Association, vol. 16(1), pages 160-189, February.
    11. Mindy Marks & Moonkyung Kate Choi, 2019. "Baby Boomlets and Baby Health: Hospital Crowdedness, Hospital Spending, and Infant Health," American Journal of Health Economics, University of Chicago Press, vol. 5(3), pages 376-406, Summer.
    12. Thomas P. Hoe, 2022. "Does Hospital Crowding Matter? Evidence from Trauma and Orthopedics in England," American Economic Journal: Economic Policy, American Economic Association, vol. 14(2), pages 231-262, May.
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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • J20 - Labor and Demographic Economics - - Demand and Supply of Labor - - - General

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