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  4. The implications of high bed occupancy rates on readmission rates in England: A longitudinal study
 
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The implications of high bed occupancy rates on readmission rates in England: A longitudinal study
File(s)
1-s2.0-S0168851019301563-main.pdf (653.81 KB)
Published version
Author(s)
Friebel, Rocco
Fisher, Rebecca
Deeny, Sarah R
Gardner, Tim
Molloy, Aoife
more
Type
Journal Article
Abstract
Hospital bed occupancy rates in the English National Health Service have risen to levels considered clinically unsafe. This study assesses the association of increased bed occupancy with changes in the percentage of overnight patients discharged from hospital on a given day, and their subsequent 30-day readmission rate. Longitudinal panel data methods are used to analyse secondary care records (n = 4,193,590) for 136 non-specialist Trusts between April 2014 and February 2016. The average bed occupancy rate across the study period was 90.4%. A 1% increase in bed occupancy was associated with a 0.49% rise in the discharge rate, and a 0.011% increase in the 30-day readmission rate for discharged patients. These associations became more pronounced once bed occupancy exceeded 95%. When bed occupancy rates were high, hospitals discharged a greater proportion of their patients. Those were mostly younger and less clinically complex, suggesting that hospitals are successfully prioritising early discharge amongst least vulnerable patients. However, while increased bed occupancy was not associated with a substantial increase in overall 30-day readmission rates, the relationship was more pronounced in older and sicker patients, indicating possible links with short-fallings in discharge processes.
Date Issued
2019-08
Date Acceptance
2019-06-17
Citation
Health Policy, 2019, 123 (8), pp.765-772
URI
http://hdl.handle.net/10044/1/73628
DOI
https://www.dx.doi.org/10.1016/j.healthpol.2019.06.006
ISSN
0168-8510
Publisher
Elsevier BV
Start Page
765
End Page
772
Journal / Book Title
Health Policy
Volume
123
Issue
8
Copyright Statement
© 2019 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.
0/).
Subjects
1117 Public Health and Health Services
1605 Policy and Administration
Health Policy & Services
Publication Status
Published
Date Publish Online
2019-06-22
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