The relationship between workload and length of stay in Singapore.


Journal Article

Prior studies link higher workload with longer length of stay (LOS) in the US. Unlike U.S. hospitals, Singaporean hospitals, like other major hospitals in the Asia-Pacific, are partially occupied by patients with non-acute needs due to insufficient alternative facilities. We examined the association between workload and length of stay (LOS) and the impact of workload on 30-day re-hospitalization and inpatient mortality rates in retrospective cohort in this setting. We defined workload as the daily number of patients per physician team. 13,097 hospitalizations of 10,000 patients were included. We found that higher workload was associated with shorter LOS (coefficient, -0.044 [95%CI, -0.083, -0.01]), especially for patients with longer stays (hazard ratios, not significantly greater than 1 before Day 4, 1.04 [95%CI, 1.01, 1.07] at Day 4 and 1.16 [95%CI, 1.10, 1.24] at Day 10), without affecting inpatient mortality (odds ratio (OR), 1.03 [95%CI, 0.99, 1.05]) or 30-day re-hospitalization (OR, 1.01 [95%CI, 0.99, 1.04]). This result differs from studies in the US and may reflect regional differences in the use of acute hospital beds for non-acute needs.

Full Text

Duke Authors

Cited Authors

  • Zhou, K; Vidyarthi, A; Matchar, D; Cheung, YB; Lam, SW; Ong, M

Published Date

  • July 2018

Published In

Volume / Issue

  • 122 / 7

Start / End Page

  • 769 - 774

PubMed ID

  • 29729904

Pubmed Central ID

  • 29729904

Electronic International Standard Serial Number (EISSN)

  • 1872-6054

Digital Object Identifier (DOI)

  • 10.1016/j.healthpol.2018.04.002


  • eng

Conference Location

  • Ireland