Impacts of congestion on healthcare outcomes: an empirical observation in China

Many studies have shown that healthcare quality such as mortality rate exhibits U-shaped curves for congestion. These studies usually focus on how the congestion rate affects the overall hospitals' mortality rate. Our study investigates the impact of congestion on two subcategories: surgical and non-surgical inpatients, using the records of 27,575 patients from a public hospital in China. We confirm that the overall mortality rate exhibits a U-shaped curve. We further show that the mortality rate of surgical patients first decreases and then almost stays unchanged as congestion level increases, while the curve for the mortality rate of non-surgical patients remains U-shaped. The initial decrease partly results from the combination of decreasing mortality and increasing peak occupancy with time. The increase is in accordance with the overwork, but the condition requirement and high standard protocols of care may cause the mortality of surgical patients to be less affected by congestion.