Quality Effect of Early Discharge of Maternity Patients: Does Hospital Specialization Matter?

摘要

The quest to reduce health care cost has led many industrialized nations to reduce hospitalnlength of stay. This paper uses instrumental variable estimation to estimate the effect of earlyndischarge on readmission rates of maternity patients in British Columbia, Canada and investigatesnhow the impact varied according to hospitals’ degree of specialization. Principal component analysisnwas used to classify the hospitals according to their degree of specialization. The results shownthat the early discharge policy increased readmission rates, and this increase, varied according tonthe degree of specialization of the hospital. The increase in readmission rate is observed to benlowest in the very highly specialized hospitals and highest in the moderately specialized hospitals.nThe highly specialized hospitals are, however, capable of using resources most efficiently at leastnpartly due to a reduction in the use of invasive procedures.