NEW YORK – Nobody wants to spend their weekend in a hospital, but for those admitted after suffering a heart attack, a weekend stay may just be what the doctor ordered. In a new study on hospital mortality rates, Columbia Business School’s Merrill Lynch Professor of Workforce Transformation Ann P. Bartel and Associate Professor of Business Carri W. Chan find that increasing heart attack patients’ length of stay by just one day could decrease 30-day mortality rates and save lives.
Thirty-day mortality rates track patient deaths after they have been discharged from the hospital as well as measure hospital quality. But despite the criticism that these metrics depend more on what each patient does after discharge rather than their in-patient care, the study, co-authored with the University of Southern California’s Song-Hee Kim, finds a causal relationship between in-patient care (length of stay) and 30-day mortality rates. The researchers conducted an econometric analysis by surveying data from every Medicare Fee-for-Service patient who suffered a heart attack from 2000 to 2011. They found that patients admitted on Mondays or Tuesdays are at greater risk of premature discharge because hospitals prefer to discharge patients before the weekend. But by adding one day to their stay, 30-day mortality rates decrease by more than 6%. Cost-benefit analysis shows that the value of 26 saved lives per year outweighs the hospital costs incurred by an extra day.
Although the study does not find the exact cause behind how an extra day improves post-discharge mortality, the researchers do point to the premature discharges that often occur right before the weekend as a way for hospitals to better patient outcomes. They suggest hospitals move to a 7-day discharge schedule, rather than limiting discharges to Monday through Friday, and encourage hospitals to reallocate resources like beds and staff so early discharges are not necessary.
The study, Should Hospitals Keep Their Patients Longer? The Role of Inpatient Care in Reducing Post-Discharge Mortality, is available online here.
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About the researchers
Professor Bartel is the Merrill Lynch Professor of Workforce Transformation at Columbia Business School and the Director of Columbia Business School's Workforce Transformation...Read more.
Professor Chan teaches the core MBA class, Operations Management. Her primary research interests are in data-driven modeling of complex stochastic systems, dynamic optimization, and...Read more.