Does hospital discharge policy influence sick-leave patterns in the case of female breast cancer?
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Does hospital discharge policy influence sick-leave patterns in the case of female breast cancer? / Lindqvist, Rikard; Stenbeck, Magnus; Diderichsen, Finn.
I: Health Policy, Bind 72, Nr. 1, 2005, s. 65-71.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Does hospital discharge policy influence sick-leave patterns in the case of female breast cancer?
AU - Lindqvist, Rikard
AU - Stenbeck, Magnus
AU - Diderichsen, Finn
N1 - Keywords: Adolescent; Adult; Age Distribution; Ambulatory Surgical Procedures; Breast Neoplasms; Female; Hospitals, Public; Humans; Length of Stay; Mastectomy; Mastectomy, Segmental; Middle Aged; Organizational Policy; Patient Discharge; Registries; Sick Leave; Sweden
PY - 2005
Y1 - 2005
N2 - The objective was to investigate how differences among hospitals in the shift from in-patient care to day surgery and a reduced hospital length of stay affect the sick-leave period for female patients surgically treated for breast cancer. All women aged 18-64 who were diagnosed with breast cancer in 2000 were selected from the National Cancer Register and combined with data from the sick-leave database of the National Social Insurance Board and the National Hospital Discharge Register (N = 1834). A multi-factorial model was fitted to the data to investigate how differences in hospital care practice affected the length of sick-leave. The main output measure was the number of sick-leave days after discharge during the year following surgery. The confounders used included age, type of primary surgical treatment, whether or not lymph node dissection was performed, labour-market status, county, and readmission. Women treated with breast-conserving surgery had a 54.7-day (-71.9 < or = CI(95%) < or = -37.5) shorter sick-leave period than those with more invasive surgery. The day-surgery cases had 24.3 (-47.5 < or = CI(95%) < or = -1.1) days shorter sick-leave than those who received overnight care. The effect of the hospital median length of stay (LOS) was U-shaped, suggesting that hospitals with a median LOS that is either short or long are associated with longer sick-leave. In the intermediate range, women treated in hospitals with a median LOS of 2 days had 22 days longer sick-leave than those treated in hospitals with a mean LOS of 3 days. This is possibly a sign of sub-optimising.
AB - The objective was to investigate how differences among hospitals in the shift from in-patient care to day surgery and a reduced hospital length of stay affect the sick-leave period for female patients surgically treated for breast cancer. All women aged 18-64 who were diagnosed with breast cancer in 2000 were selected from the National Cancer Register and combined with data from the sick-leave database of the National Social Insurance Board and the National Hospital Discharge Register (N = 1834). A multi-factorial model was fitted to the data to investigate how differences in hospital care practice affected the length of sick-leave. The main output measure was the number of sick-leave days after discharge during the year following surgery. The confounders used included age, type of primary surgical treatment, whether or not lymph node dissection was performed, labour-market status, county, and readmission. Women treated with breast-conserving surgery had a 54.7-day (-71.9 < or = CI(95%) < or = -37.5) shorter sick-leave period than those with more invasive surgery. The day-surgery cases had 24.3 (-47.5 < or = CI(95%) < or = -1.1) days shorter sick-leave than those who received overnight care. The effect of the hospital median length of stay (LOS) was U-shaped, suggesting that hospitals with a median LOS that is either short or long are associated with longer sick-leave. In the intermediate range, women treated in hospitals with a median LOS of 2 days had 22 days longer sick-leave than those treated in hospitals with a mean LOS of 3 days. This is possibly a sign of sub-optimising.
U2 - 10.1016/j.healthpol.2004.06.003
DO - 10.1016/j.healthpol.2004.06.003
M3 - Journal article
C2 - 15760699
VL - 72
SP - 65
EP - 71
JO - Health Policy
JF - Health Policy
SN - 0168-8510
IS - 1
ER -
ID: 8855315