The average length of stay (ALOS) is a key New Public Management (NPM) indicator intended to represent cost-effectiveness of hospitals. However, this indicator is fundamentally biased in that it depends largely on the kind of patients that are factored into the figure. Based on an ethnographic survey of a follow-up care ward and a statistical analysis, we show that a patient’s length of stay hinges on three factors: events, ties to relatives, and social connections within wider society. Thus, for a health care provider, lowering its ALOS primarily translates to avoiding patients needing the greatest amount of care.
- health care
- New Public Management