Exploring the causal relationship between length of stay in hospitals and treatment outcome: Evidence from Japanese AMI patients

Satoshi Shimizutani, Hiroyuki Yamada, Haruko Noguchi, Yuichiro Masuda and Masafumi Kuzuya
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Yuichiro Masuda: MD, Director of Medicine, Gifu Health Management Center
Masafumi Kuzuya: MD, Professor, Graduate School of Medicine, Nagoya University

No 13E006, OSIPP Discussion Paper from Osaka School of International Public Policy, Osaka University

Abstract: In this study, we explore the causal relationship between length of stay (LOS) in hospitals and the treatment outcome for Acute Myocardial Infarction (AMI) patients in Japan, where the average LOS (ALOS) is the longest among OECD countries. Using chart-based data, we address the endogeneity between LOS and treatment outcome by using an exogenous variation based on Rokuyo (the six basic labels allocated to each weekday), which is found to be irrelevant to admission day but relevant to discharge day. While we do find a significant association between LOS and rehospitalization probability in the ordinary least squares (OLS) estimation, we do not find a significant relationship once LOS is instrumented by the six basic labels in various instrumental variable estimations. This implies that additional stay that was induced owing to patient's choice of preferred Rokuyo at discharge has no effect on rehospitalization probability.

Keywords: Japan; Rokuyo; Length of stay; Hospitals; Rehospitalization; Health expenditure. (search for similar items in EconPapers)
JEL-codes: I11 I18 (search for similar items in EconPapers)
Pages: 31 pages
Date: 2013-09
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Persistent link: https://EconPapers.repec.org/RePEc:osp:wpaper:13e006

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