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The effect of workforce assignment on performance: Evidence from home health care

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  • David, Guy
  • Kim, Kunhee Lucy

Abstract

Effective workforce assignment has the potential for improving performance. Using novel home health data combining provider work logs, personnel data, and detailed patient records, we estimate the effect of provider handoffs—a marker of care discontinuity—on hospital readmissions, an important performance measure for healthcare systems. We use workflow interruption caused by attrition and providers’ work inactivity as an instrument for nurse handoffs. We find handoffs to substantially increase hospital readmissions. Our estimates imply that a single handoff increases the likelihood of 30-day hospital readmission by 16 percent and one in four hospitalizations during home health care would be avoided if handoffs were eliminated. Moreover, handoffs are more detrimental for high-severity patients and expedite hospital readmission. The frequency and sequencing of handoffs also affect the likelihood of rehospitalization.

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  • David, Guy & Kim, Kunhee Lucy, 2018. "The effect of workforce assignment on performance: Evidence from home health care," Journal of Health Economics, Elsevier, vol. 59(C), pages 26-45.
    • Handle: RePEc:eee:jhecon:v:59:y:2018:i:c:p:26-45
    DOI: 10.1016/j.jhealeco.2018.03.003
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    References listed on IDEAS

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    1. Alexandre Mas & Enrico Moretti, 2009. "Peers at Work," American Economic Review, American Economic Association, vol. 99(1), pages 112-145, March.
    2. Daniel S. Hamermesh & Gerard A. Pfann, 1996. "Adjustment Costs in Factor Demand," Journal of Economic Literature, American Economic Association, vol. 34(3), pages 1264-1292, September.
    3. Hyunjee Kim & Edward C. Norton, 2015. "Practice Patterns among Entrants and Incumbents in the Home Health Market after the Prospective Payment System was Implemented," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 118-131, March.
    4. Cook, Andrew & Gaynor, Martin & Stephens Jr, Melvin & Taylor, Lowell, 2012. "The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation," Journal of Health Economics, Elsevier, vol. 31(2), pages 340-348.
    5. Jing Guo & R. Tamara Konetzka & Willard G. Manning, 2015. "The Causal Effects of Home Care Use on Institutional Long‐Term Care Utilization and Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 4-17, March.
    6. Luis Garicano & Tano Santos, 2004. "Referrals," American Economic Review, American Economic Association, vol. 94(3), pages 499-525, June.
    7. Tanguy Brachet & Guy David & Andrea M. Drechsler, 2012. "The Effect of Shift Structure on Performance," American Economic Journal: Applied Economics, American Economic Association, vol. 4(2), pages 219-246, April.
    8. Jing Guo & R. Tamara Konetzka & Willard G. Manning, 2015. "The Causal Effects of Home Care Use on Institutional Long‐Term Care Utilization and Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 4-17, March.
    9. Polsky, Daniel & David, Guy & Yang, Jianing & Kinosian, Bruce & Werner, Rachel M., 2014. "The effect of entry regulation in the health care sector: The case of home health," Journal of Public Economics, Elsevier, vol. 110(C), pages 1-14.
    10. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    11. Lin, Haizhen, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 37(C), pages 13-24.
    12. Linda V. Green & Sergei Savin & Nicos Savva, 2013. "“Nursevendor Problem”: Personnel Staffing in the Presence of Endogenous Absenteeism," Management Science, INFORMS, vol. 59(10), pages 2237-2256, October.
    13. Robert S. Huckman & Gary P. Pisano, 2006. "The Firm Specificity of Individual Performance: Evidence from Cardiac Surgery," Management Science, INFORMS, vol. 52(4), pages 473-488, April.
    14. Woodward, Christel A. & Abelson, Julia & Tedford, Sara & Hutchison, Brian, 2004. "What is important to continuity in home care?: Perspectives of key stakeholders," Social Science & Medicine, Elsevier, vol. 58(1), pages 177-192, January.
    15. Song-Hee Kim & Carri W. Chan & Marcelo Olivares & Gabriel Escobar, 2015. "ICU Admission Control: An Empirical Study of Capacity Allocation and Its Implication for Patient Outcomes," Management Science, INFORMS, vol. 61(1), pages 19-38, January.
    16. Steven G. Allen, 1983. "How Much Does Absenteeism Cost?," Journal of Human Resources, University of Wisconsin Press, vol. 18(3), pages 379-393.
    17. Jason M. Hockenberry & Edmund R. Becker, 2016. "How Do Hospital Nurse Staffing Strategies Affect Patient Satisfaction?," ILR Review, Cornell University, ILR School, vol. 69(4), pages 890-910, August.
    18. Guy David & Evan Rawley & Daniel Polsky, 2013. "Integration and Task Allocation: Evidence from Patient Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 22(3), pages 617-639, September.
    19. Ehrenberg, Ronald G, 1970. "Absenteeism and the Overtime Decision," American Economic Review, American Economic Association, vol. 60(3), pages 352-357, June.
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    Cited by:

    1. Norma B. Coe & Jing Guo & R. Tamara Konetzka & Courtney Harold Van Houtven, 2019. "What is the marginal benefit of payment‐induced family care? Impact on Medicaid spending and health of care recipients," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 678-692, May.
    2. Saad Zbiri & Patrick Rozenberg & Carine Milcent, 2024. "Staff Resources in Public and Private Hospitals and Their Implication for Medical Practice: A French Study of Caesareans," Post-Print hal-04626835, HAL.
    3. Lorena Martini & Luigi Apuzzo & Daniele Pandolfi & Irene Gabutti & Domenico Mantoan, 2022. "La programmazione del personale sanitario in ambito territoriale: una revisione sistematica della letteratura e analisi del contesto italiano in base al PNRR e DM77/2022," MECOSAN, FrancoAngeli Editore, vol. 2022(124), pages 7-43.
    4. Bernard Bensaid & Solen Croiset & Robert J. Gary-Bobo, 2022. "Economies of Density, Team Synergies and Unobserved Heterogeneity: A Study of Home Care Services," CESifo Working Paper Series 9864, CESifo.
    5. Atul Gupta & Guy David & Lucy Kim, 2023. "The effect of performance pay incentives on market frictions: evidence from medicare," International Journal of Health Economics and Management, Springer, vol. 23(1), pages 27-57, March.
    6. Hummy Song & Elena Andreyeva & Guy David, 2022. "Time Is the Wisest Counselor of All: The Value of Provider–Patient Engagement Length in Home Healthcare," Management Science, INFORMS, vol. 68(1), pages 420-441, January.

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