Does Hospital Crowding Matter? Evidence from Trauma and Orthopedics in England

Abstract

This paper estimates the impact of hospital crowding on medical treatment decisions and patient health outcomes. Exploiting pseudorandom variation in emergency admissions, I find that a one-standard-deviation admission shock increases the unplanned readmission rate by 4.1 percent. Nonparametric and heterogeneity analyses suggest that “quicker and sicker” discharges contribute to the additional readmissions. The crowding impacts are larger in hospital departments with fewer beds, sicker patients, and stronger incentives to admit nonemergency patients. (JEL H51, I11, I12, I18)