Exploring the causal relationship between length of stay in hospitals and treatment outcome: Evidence from Japanese AMI patients
In this study, we explore the causal relationship between length of stay (LOS) in hospitals and the treatment outcome for Acute Myocardial Infarction (AMI) patients in Japan, where the average LOS (ALOS) is the longest among OECD countries. Using chart-based data, we address the endogeneity between LOS and treatment outcome by using an exogenous variation based on Rokuyo (the six basic labels allocated to each weekday), which is found to be irrelevant to admission day but relevant to discharge day. While we do find a significant association between LOS and rehospitalization probability in the ordinary least squares (OLS) estimation, we do not find a significant relationship once LOS is instrumented by the six basic labels in various instrumental variable estimations. This implies that additional stay that was induced owing to patient's choice of preferred Rokuyo at discharge has no effect on rehospitalization probability.
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- Haruko Noguchi & Satoshi Shimizutani & Yuichiro Masuda, 2008.
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International Journal of Health Care Finance and Economics,
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