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Skill mix and patient outcomes: A multi-country analysis of heart disease and breast cancer patients

Author

Listed:
  • Kopasker, Daniel
  • Islam, M. Kamrul
  • Gibson, Jonathan
  • Lau, Yiu-Shing
  • Sutton, Matt
  • Askildsen, Jan Erik
  • Bond, Christine
  • Elliott, Robert

Abstract

Policymakers are becoming aware that increasing the size of the healthcare workforce is no longer the most viable way to address the increasing demand for healthcare. Consequently, a focus of recent healthcare workforce reform has been extending existing roles and creating new roles for health professionals. However, little is known of the influence on outcomes from this variation in labour inputs within hospital production functions. Using a unique combination of primary and administrative data, this paper provides evidence of associations between the composition of care delivery teams and patient outcomes. The primary data enabled the construction of a task component-based measure of skill mix. This novel measure of skill mix has the advantage of capturing how workforce planning can restructure the relative input of nurses or physicians into task components while keeping the overall level of staff fixed. The analysis focuses on specific care pathways and individual hospitals, thus controlling for an under-investigated source of heterogeneity. Additionally, stratifying by country (England, Scotland, and Norway) enabled analysis of skill mix within different health systems. We provide evidence that variations in labour inputs within the breast cancer and heart disease care pathways are associated with both positive and adverse outcomes. The results illustrate the scope for substitution of task components within care pathways as a potential method of healthcare reform.

Suggested Citation

  • Kopasker, Daniel & Islam, M. Kamrul & Gibson, Jonathan & Lau, Yiu-Shing & Sutton, Matt & Askildsen, Jan Erik & Bond, Christine & Elliott, Robert, 2020. "Skill mix and patient outcomes: A multi-country analysis of heart disease and breast cancer patients," Health Policy, Elsevier, vol. 124(10), pages 1074-1082.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:10:p:1074-1082
    DOI: 10.1016/j.healthpol.2020.07.009
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    References listed on IDEAS

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    1. Michael Koch, 2016. "Skills, Tasks and the Scarcity of Talent in a Global Economy," Review of International Economics, Wiley Blackwell, vol. 24(3), pages 536-563, August.
    2. Köppen, Julia & Maier, Claudia B. & Busse, Reinhard, 2018. "What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians, nurses and managers looking at breast cancer and acute myocardial ," Health Policy, Elsevier, vol. 122(10), pages 1118-1125.
    3. Acemoglu, Daron & Autor, David, 2011. "Skills, Tasks and Technologies: Implications for Employment and Earnings," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 12, pages 1043-1171, Elsevier.
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    More about this item

    Keywords

    Skill mix; Substitution; Health workforce; Patient outcomes; Hospital production function;
    All these keywords.

    JEL classification:

    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General

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