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Does Hospital Crowding Matter? Evidence from Trauma and Orthopedics in England

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  • Thomas P. Hoe

Abstract

This paper estimates the impact of hospital crowding on medical treatment decisions and patient health outcomes. Exploiting pseudorandom variation in emergency admissions, I find that a one-standard-deviation admission shock increases the unplanned readmission rate by 4.1 percent. Nonparametric and heterogeneity analyses suggest that "quicker and sicker" discharges contribute to the additional readmissions. The crowding impacts are larger in hospital departments with fewer beds, sicker patients, and stronger incentives to admit nonemergency patients.

Suggested Citation

  • 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.
    • Handle: RePEc:aea:aejpol:v:14:y:2022:i:2:p:231-62
    DOI: 10.1257/pol.20180672
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    Citations

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    Cited by:

    1. Bachner, Florian & Halla, Martin & Pruckner, Gerald J., 2024. "Do Empty Beds Cause Cesarean Deliveries?," IZA Discussion Papers 16981, Institute of Labor Economics (IZA).
    2. 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.
    3. Martin B. Hackmann & R. Vincent Pohl & Nicolas R. Ziebarth, 2024. "Patient versus Provider Incentives in Long-Term Care," American Economic Journal: Applied Economics, American Economic Association, vol. 16(3), pages 178-218, July.
    4. Kovacs, Roxanne J. & Lagarde, Mylène, 2022. "Does high workload reduce the quality of healthcare? Evidence from rural Senegal," LSE Research Online Documents on Economics 113759, London School of Economics and Political Science, LSE Library.
    5. 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).
    6. Francetic, Igor & Meacock, Rachel & Sutton, Matt, 2024. "Free-for-all: Does crowding impact outcomes because hospital emergency departments do not prioritise effectively?," Journal of Health Economics, Elsevier, vol. 95(C).
    7. Stoye, George & Warner, Max, 2023. "The effects of doctor strikes on patient outcomes: Evidence from the English NHS," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 689-707.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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