Abstract

Healthcare services provided to patients with similar health conditions are known to vary. Standardization of healthcare delivery is a relatively new, yet hotly debated approach to address clinical variations. Previous research on process standardization in health services has focused on measuring adherence to established protocols that are available only for a limited set of disease states. We create an alternate construct that quantifies process standardization measured in terms of consistency of services rendered, and apply it to the healthcare setting using detailed nonpublic inpatient discharge data from about 35 million inpatient stays at 296 acute care hospitals in California between 2008-2016. We examine the impact of such process standardization on the cost, quality, and variation in quality of care delivered at the hospital, operating unit, and disease state level. We find that process standardization is associated with a reduction in cost per discharge, readmission rates and variation in readmission rates at the hospital level. We also find that the impact of process standardization varies across different operating units and disease states, providing cost and quality benefit in majority of cases. We further conduct post-hoc analysis on the degree of process standardization, finding that higher rates of capacity utilization and complexity of patient disease mix is associated with a lower process standardization, while increasing focus and process adherence is associated with an increase in process standardization.

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• Keyword(s):
• healthcare 76
• operations 147