Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/29930 
Year of Publication: 
2009
Series/Report no.: 
Ruhr Economic Papers No. 105
Publisher: 
Rheinisch-Westfälisches Institut für Wirtschaftsforschung (RWI), Essen
Abstract: 
This paper investigates the relationship between health outcomes and variations in staffing levels as approximated by admissions on weekdays versus admissions on weekends. Because days of admission are potentially endogenous, we instrument on emergency admissions only, which are reasonably exogenous to the time of admission. Further, we introduce a direct measure for within-diagnosis variation in severity across days of admission to control for the unobservable selection of patients. We find that after controlling for patient heterogeneity and endogeneity of the day of admission there is still a significant variation in mortality rates between weekend and weekday admissions. Patients admitted during the weekend exhibit higher in-hospital mortality rates. We also find signs of premature discharge, as patients with short lengths of stay tend to exhibit higher probability to be readmitted as emergency cases.
Subjects: 
Hospital quality
weekend effect
inpatient outcomes
JEL: 
I12
I18
ISBN: 
978-3-86788-117-3
Document Type: 
Working Paper

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