Back

The Effect of Length of Stay in Hospital on Patients' Health Outcomes: A Quasi-Experimental Study

Langenberger, B.; Worsham, C.; Geldsetzer, P.

2024-12-03 health economics
10.1101/2024.12.02.24318326 medRxiv
Show abstract

The causal effect of hospital length of stay on crucial patient out-comes such as readmissions or mortality is under-investigated and therefore unknown for the vast majority of the US population. Existing evidence stems from association studies that are unable to draw causal conclusions. This study leverages Medicares two-midnight (2MN) and three-day (3D) rules as two natural experiments to establish causal rela-tionships between hospital length of stay (LOS) and patient outcomes. Using a quasi-experimental regression discontinuity design with data from a large US hospital, we find that the 2MN rule increases LOS by 0.10 days and the 3D rule by 0.21 days, confirming the validity of these rules as instruments for causal inference. However, despite these increases in LOS, there are no significant effects on 90-day mortality or 30-day readmission rates. These findings suggest that while the 2MN and 3D rules effectively extend hospital stays, they do not im-prove patient-related outcomes, indicating an inefficient use of hospital resources.

Matching journals

The top 3 journals account for 50% of the predicted probability mass.

50% of probability mass above

"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.