Demand, selection and patient outcomes in German acute care hospitals
研究了德国急症医院中意外需求波动对患者结局（如院内死亡率）的影响，发现医院通过调整住院时长（如提前出院择期患者、推迟高风险急诊患者出院）有效应对了需求冲击，未对患者结局产生负面影响。
This paper examines the effects of variation in unexpected demand on patient outcomes in acute care German hospitals. Naturally, an unexpected surge in demand may negatively affect the quality of care and thus patient outcomes, such as in-hospital mortality. We estimate models explaining patient outcomes depending on demand, unobservable patient selection and seasonal factors, as well as patient-specific risk factors and unobservable hospital and department fixed-effects. The main message of this analysis is that hospitals are well prepared to deal with this unexpected volatility in demand, as by and large it does not negatively affect patient outcomes. Hospitals seem to deal with high unexpected workload by steering the patients' length of stay relating to their severity of illness. Elective patients are discharged earlier, while discharges of high-risk emergency patients are postponed.