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Health service costs in Europe: cost and reimbursement of primary hip replacement in nine countries

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  • Tom Stargardt

Abstract

This paper assesses variations in the cost of primary hip replacement between and within nine member states of the European Union (EU). It also compares the cost of service with public‐payer reimbursements. To do so, data on cost and reimbursement were surveyed at the micro‐level in 42 hospitals in Denmark, England, France, Germany, Hungary, Italy, The Netherlands, Poland, and Spain. The total cost of treatment ranged from €1290 (Hungary) to €8739 (The Netherlands), with a mean cost of €5043 (STD±€2071). The main cost drivers were found to be implants (34% of total cost on average) and ward costs (20.9% of total cost on average). A one‐way random effects analysis of variance model indicated that 74.0% of variation was between and only 26% of variation was within countries. In a two‐level random‐intercept regression model, purchasing‐power parities explained 79.4% of the explainable between‐country variation, while the percentage of uncemented implants used and the number of beds explained 12.1 and 1.6% of explainable within‐country variation, respectively. The large differences in cost and reimbursement between Poland, Hungary, and the other EU member states shows that primary total hip replacement is a highly relevant case for cross‐border care. Copyright © 2008 John Wiley & Sons, Ltd.

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  • Tom Stargardt, 2008. "Health service costs in Europe: cost and reimbursement of primary hip replacement in nine countries," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 9-20, January.
    • Handle: RePEc:wly:hlthec:v:17:y:2008:i:s1:p:s9-s20
    DOI: 10.1002/hec.1328
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    1. Laudicella, Mauro & Siciliani, Luigi & Cookson, Richard, 2012. "Waiting times and socioeconomic status: Evidence from England," Social Science & Medicine, Elsevier, vol. 74(9), pages 1331-1341.
    2. Majo, M.C., 2010. "A microeconometric analysis of health care utilization in Europe," Other publications TiSEM 1cf5fd2f-8146-4ef8-8eb5-e, Tilburg University, School of Economics and Management.
    3. Majo, Maria Cristina & van Soest, Arthur, 2012. "Income and health care utilization among the 50+ in Europe and the US," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 28(4), pages 3-22.
    4. Melberg, Hans Olav, 2011. "Some problems with international comparisons of health spending – and a suggestion about how to quantify the size of the problems," HERO Online Working Paper Series 2011:4, University of Oslo, Health Economics Research Programme.
    5. Reinhard Busse & on behalf of the EuroDRG group, 2012. "DO DIAGNOSIS‐RELATED GROUPS EXPLAIN VARIATIONS IN HOSPITAL COSTS AND LENGTH OF STAY? – ANALYSES FROM THE EURODRG PROJECT FOR 10 EPISODES OF CARE ACROSS 10 EuroPEAN COUNTRIES," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 1-5, August.
    6. Felix Rohrer & Aresh Farokhnia & Hubert Nötzli & Frederik Haubitz & Tanja Hermann & Brigitta Gahl & Andreas Limacher & Jan Brügger, 2022. "Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements," IJERPH, MDPI, vol. 19(7), pages 1-15, April.
    7. Eberhard Feess & Helge Müller & Ansgar Wohlschlegel, 2019. "Reimbursement schemes for hospitals: the impact of case and firm characteristics," Applied Economics, Taylor & Francis Journals, vol. 51(15), pages 1647-1665, March.
    8. Alexander Geissler & David Scheller‐Kreinsen & Wilm Quentin & on behalf of the EuroDRG group, 2012. "Do Diagnosis‐Related Groups Appropriately Explain Variations In Costs And Length Of Stay Of Hip Replacement? A Comparative Assessment Of Drg Systems Across 10 European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 103-115, August.
    9. Jonas Schreyögg & Oliver Tiemann & Tom Stargardt & Reinhard Busse, 2008. "Cross‐country comparisons of costs: the use of episode‐specific transitive purchasing power parities with standardised cost categories," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 95-103, January.
    10. 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 1-8, January.
    11. Luigi Siciliani & Peter Sivey & Andrew Street, 2013. "Differences In Length Of Stay For Hip Replacement Between Public Hospitals, Specialised Treatment Centres And Private Providers: Selection Or Efficiency?," Health Economics, John Wiley & Sons, Ltd., vol. 22(2), pages 234-242, February.
    12. Glinos, Irene A. & Baeten, Rita & Maarse, Hans, 2010. "Purchasing health services abroad: Practices of cross-border contracting and patient mobility in six European countries," Health Policy, Elsevier, vol. 95(2-3), pages 103-112, May.

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