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Examining cost variation across hospital departments-a two-stage multi-level approach using patient-level data

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  • Laudicella, Mauro
  • Olsen, Kim Rose
  • Street, Andrew

Abstract

Studies of hospital efficiency seldom lead to changes in practice, partly because recommendations are unspecific or results are not seen as robust. We describe a method to compare hospital costs that utilises patient-level data. We perform a two-stage analysis in which we first consider factors that explain costs among patients and then across hospital departments. We illustrate our approach by examining the costs and characteristics of almost one million patients admitted to 136 English NHS hospital obstetrics departments in 2005/2006. We identify those departments with significantly higher costs that need to take action.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 71 (2010)
Issue (Month): 10 (November)
Pages: 1872-1881

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Handle: RePEc:eee:socmed:v:71:y:2010:i:10:p:1872-1881

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Keywords: UK Hospital efficiency Multi-level modelling Prospective payment Obstetrics Hospital costs;

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Cited by:
  1. Carine Milcent, 2014. "Coût des soins hospitaliers : effet de la concurrence par la qualité," PSE Working Papers halshs-01010327, HAL.
  2. Nils Gutacker & Chris Bojke & Silvio Daidone & Nancy J. Devlin & David Parkin & Andrew Street, 2013. "Truly Inefficient Or Providing Better Quality Of Care? Analysing The Relationship Between Risk‐Adjusted Hospital Costs And Patients' Health Outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 22(8), pages 931-947, 08.
  3. John Buckell & Andrew Smith & Roberta Longo & David Holland, 2013. "Health inefficiency and unobservable heterogeneity - empirical evidence from pathology services in the UK National Health Service," Working Papers 1307, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
  4. Troels Kristensen & Kim Olsen & Henrik Schroll & Janus Thomsen & Anders Halling, 2014. "Association between fee-for-service expenditures and morbidity burden in primary care," The European Journal of Health Economics, Springer, vol. 15(6), pages 599-610, July.
  5. Marie Kruse & Jan Christensen, 2013. "Is quality costly? Patient and hospital cost drivers in vascular surgery," Health Economics Review, Springer, vol. 3(1), pages 1-13, December.
  6. Gyrd-Hansen, Dorte & Olsen, Kim R. & Sørensen, Torben H., 2012. "Socio-demographic patient profiles and hospital efficiency: Does patient mix affect a hospital's ability to perform?," Health Policy, Elsevier, vol. 104(2), pages 136-145.
  7. Daidone, Silvio & Street, Andrew, 2013. "How much should be paid for specialised treatment?," Social Science & Medicine, Elsevier, vol. 84(C), pages 110-118.
  8. Kristensen, Troels & Rose Olsen, Kim & Sortsø, Camilla & Ejersted, Charlotte & Thomsen, Janus Laust & Halling, Anders, 2013. "Resources allocation and health care needs in diabetes care in Danish GP clinics," Health Policy, Elsevier, vol. 113(1), pages 206-215.
  9. Johns, Benjamin & Steinhardt, Laura & Walker, Damian G. & Peters, David H. & Bishai, David, 2013. "Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: A seemingly unrelated regression approach," Social Science & Medicine, Elsevier, vol. 89(C), pages 25-31.
  10. Bache, Stefan Holst Milton & Kristensen, Troels, 2013. "A simple but efficient approach to the analysis of multilevel data," COHERE Working Paper 2013:6, COHERE - Centre of Health Economics Research, University of Southern Denmark.
  11. James Gaughan & Anne Mason & Andrew Street & Padraic Ward, 2012. "English Hospitals Can Improve Their Use of Resources: An Analysis of Costs and Length of Stay for Ten Treatments," Working Papers 078cherp, Centre for Health Economics, University of York.
  12. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2014. "Using DEA to estimate potential savings at GP units at medical specialty level," Socio-Economic Planning Sciences, Elsevier, vol. 48(1), pages 38-48.

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