Variations in hospitalisation costs for acute myocardial infarction

This file is part of IDEAS, which uses RePEc data

Variations in hospitalisation costs for acute myocardial infarction - a comparison across Europe

Author Info

Oliver Tiemann (Department of Health Care Management, Berlin University of Technology, Germany)

Abstract

The aim of this study was to determine whether between-country variations in hospital costs are larger than within-country variations and, furthermore, to explore reasons for this variability. For this purpose, we chose the primary treatment of patients with acute myocardial infarction (AMI) as an episode of care. We obtained hospitalisation costs and reimbursement rates from 45 hospitals in nine different EU member states (i.e. Denmark, England, France, Germany, Hungary, Italy, Netherlands, Poland, and Spain) for the year 2005. To further analyse the variations in hospital costs, we employed a hierarchical random effects model based on treatment and hospital characteristics and using purchasing power parities (PPPs) as a proxy for country-specific price levels. The between-country standard error was estimated at €2473, whereas the within-country standard error was estimated at €1242. Our regression analysis showed that percutaneous coronary intervention was associated with significantly increased hospitals costs compared to other treatment strategies. We were able to distinguish between three groups of countries with different cost levels based on the number of hospitals that were able to provide these services (i.e. percutaneous transluminal coronary angioplasty (PTCA) with intracoronary stenting). Excluding Hungary, Poland, and Spain, where none of the participating hospitals were able to provide these procedures, the between-country standard error decreased to €1632, whereas the within-country standard error increased to €1416. Finally, we observed exogenous price-level effects between countries and within countries for hospitals located in urban areas. Copyright © 2008 John Wiley & Sons, Ltd.

Download Info
To download:

If you experience problems downloading a file, check if you have the proper application to view it first. Information about this may be contained in the File-Format links below. In case of further problems read the IDEAS help file. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): S1 ()
Pages: S33-S45
Download reference. The following formats are available: HTML, plain text, BibTeX, RIS (EndNote), ReDIF
Handle: RePEc:wly:hlthec:v:17:y:2008:i:s1:p:s33-s45

Contact details of provider:
Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

For technical questions regarding this item, or to correct its listing, contact: (Christopher F. Baum).

Related research
Keywords:

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

Richard Grieve & Richard Nixon & Simon G. Thompson & Charles Normand, 2005. "Using multilevel models for assessing the variability of multinational resource use and cost data," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 185-196. [Downloadable!]
Laura Lambie & Soeren Mattke, 2004. "Selecting Indicators for the Quality of Cardiac Care at the Health Systems Level in OECD Countries," OECD Health Technical Papers 14, OECD Directorate for Employment, Labour and Social Affairs. [Downloadable!]
Edward Evans & Yuichi Imanaka & Miho Sekimoto & Tatsuro Ishizaki & Kenshi Hayashida & Haruhisa Fukuda & Eun-Hwan Oh, 2007. "Risk adjusted resource utilization for AMI patients treated in Japanese hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 347-359. [Downloadable!]
Brigitte Dormont & Carine Milcent, 2004. "The sources of hospital cost variability," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 927-939. [Downloadable!]
Hausman, Jerry A, 1978. "Specification Tests in Econometrics," Econometrica, Econometric Society, vol. 46(6), pages 1251-71, November. [Downloadable!] (restricted)
Breyer, Friedrich, 1987. "The specification of a hospital cost function : A comment on the recent literature," Journal of Health Economics, Elsevier, vol. 6(2), pages 147-157, June. [Downloadable!] (restricted)
Guillem López-Casasnovas & Marc Saez, 1999. "The impact of teaching status on average costs in Spanish hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 641-651.
Evans III, John H. & Hwang, Yuhchang & Nagarajan, Nandu J., 2001. "Management control and hospital cost reduction: additional evidence," Journal of Accounting and Public Policy, Elsevier, vol. 20(1), pages 73-88. [Downloadable!] (restricted)

Full references

Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

Reinhard Busse & Jonas Schreyögg & Peter C. Smith, 2008. "Variability in healthcare treatment costs amongst nine EU countries - results from the HealthBASKET project," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S1-S8. [Downloadable!]

Statistics

Access and download statistics

Did you know? IDEAS is also providing many rankings, for example of authors and institutions.

This page was last updated on 2008-8-28.

This information is provided to you by IDEAS at the Department of Economics, College of Liberal Arts and Sciences, University of Connecticut using RePEc data on a server sponsored by the Society for Economic Dynamics.