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Marginal revenue and length of stay in inpatient psychiatry

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  • Mark Pletscher

    (University of Neuchâtel
    Zurich University of Applied Sciences)

Abstract

This study examines the changes in marginal revenue during psychiatric inpatient stays in a large Swiss psychiatric hospital after the introduction of a mixed reimbursement system with tariff rates that vary over length of stay. A discrete time duration model with a difference-in-difference specification and time-varying coefficients is estimated to assess variations in policy effects over length of stay. Among patients whose costs are fully reimbursed by the mixed scheme, the model demonstrates a significant effect of marginal revenue on length of stay. No significant policy effects are found among patients for whom only health insurance rates are delivered as mixed tariffs and government contributions are made retrospectively. The results indicate that marginal revenue can affect length of stay in inpatient psychiatry facilities, but that the reduction in marginal revenue must be sufficiently large.

Suggested Citation

  • Mark Pletscher, 2016. "Marginal revenue and length of stay in inpatient psychiatry," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(7), pages 897-910, September.
    • Handle: RePEc:spr:eujhec:v:17:y:2016:i:7:d:10.1007_s10198-015-0735-4
    DOI: 10.1007/s10198-015-0735-4
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    References listed on IDEAS

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    Cited by:

    1. Clara Pott & Tom Stargardt & Udo Schneider & Simon Frey, 2021. "Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 101-114, February.

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    More about this item

    Keywords

    Prospective payment; Marginal price effect; Hospital; Psychiatry; Length of stay;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C41 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Duration Analysis; Optimal Timing Strategies

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