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The impact of inpatient bed capacity on length of stay

Author

Listed:
  • Brendan Walsh

    (Economic and Social Research Institute
    Trinity College Dublin)

  • Samantha Smith

    (Trinity College Dublin)

  • Maev-Ann Wren

    (Economic and Social Research Institute
    Trinity College Dublin)

  • James Eighan

    (Economic and Social Research Institute)

  • Seán Lyons

    (Economic and Social Research Institute
    Trinity College Dublin)

Abstract

Objective Large reductions in inpatient length of stay and inpatient bed supply have occurred across health systems in recent years. However, the direction of causation between length of stay and bed supply is often overlooked. This study examines the impact of changes to inpatient bed supply, as a result of recession-induced healthcare expenditure changes, on emergency inpatient length of stay in Ireland between 2010 and 2015. Study design We analyse all public hospital emergency inpatient discharges in Ireland from 2010 to 2015 using the administrative Hospital In-Patient Enquiry dataset. We use changes to inpatient bed supply across hospitals over time to examine the impact of bed supply on length of stay. Linear, negative binomial, and hospital–month-level fixed effects models are estimated. Results U-shaped trends are observed for both average length of stay and inpatient bed supply between 2010 and 2015. A consistently large positive relationship is found between bed supply and length of stay across all regression analyses. Between 2010 and 2012 while length of stay fell by 6.4%, our analyses estimate that approximately 42% (2.7% points) of this reduction was associated with declines in bed supply. Conclusion Changes in emergency inpatient length of stay in Ireland between 2010 and 2015 were closely related to changes in bed supply during those years. The use of length of stay as an efficiency measure should be understood in the contextual basis of other health system changes. Lower length of stay may be indicative of the lack of resources or available bed supply as opposed to reduced demand for care or the shifting of care to other settings.

Suggested Citation

  • Brendan Walsh & Samantha Smith & Maev-Ann Wren & James Eighan & Seán Lyons, 2022. "The impact of inpatient bed capacity on length of stay," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(3), pages 499-510, April.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:3:d:10.1007_s10198-021-01373-2
    DOI: 10.1007/s10198-021-01373-2
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    References listed on IDEAS

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    Cited by:

    1. Xidong Guo & Eóin T. Flaherty & Huihui Li & Jiming Zhu, 2024. "The More Private Patients, the Fewer Public Patients? Evaluating the 2014 Hospitals Reform in Ireland," Working Papers 202403, Geary Institute, University College Dublin.
    2. Siverskog, Jonathan & Henriksson, Martin, 2022. "The health cost of reducing hospital bed capacity," Social Science & Medicine, Elsevier, vol. 313(C).

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