Impact of Capacity Strain on the Health Status of Patients Discharged From an Intensive Care Unit
利用大型教学医院数据，研究发现ICU容量压力不影响出院患者健康，但会缩短住院时长（最多不到半天），并通过提前出院来缓解压力，同时减少入院量。
Intensive care units (ICUs) play a vital role in hospitals and often experience capacity strain. Using data from a large teaching hospital, we empirically examine the effect of ICU capacity strain on patient discharge. We find that capacity strain has no effect on the health status of discharged patients and that capacity strain leads to a shorter length-of-stay in the ICU, but the magnitude of the effect is less than half a day in the most extreme scenarios. In post-hoc analyses, we find evidence the discharge process is expedited by starting discharges earlier in the day when capacity is strained, demonstrating that more efficient discharges can free up space without compromising patient health. In addition, we find a decrease in patient admissions during periods of capacity strain. To our knowledge, this is the first study to examine the direct relationship between ICU capacity strain and patient health at discharge, and it builds on the existing literature that has examined the effects of ICU capacity strain on proxies for patient health at discharge. We advocate that hospitals use outcome measures based on patient status at discharge to accurately assess the impact of capacity strain on quality of care. In addition, our work highlights the need for tailored research approaches and management practices for different types of ICUs, as generalizing the impact of ICU capacity strain across different settings may lead to inaccuracies.