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A Window on Geographic Variation in Health Care: Insights from EuroHOPE

Author

Listed:
  • Richard Heijink
  • Peter Engelfriet
  • Clas Rehnberg
  • Sverre A. C. Kittelsen
  • Unto Häkkinen
  • on behalf of the EuroHOPE study group

Abstract

The aim of EuroHOPE was to provide new evidence on the performance of healthcare systems, using a disease‐based approach, linkable patient‐level data and internationally standardized methods. This paper summarizes its main results. In the seven EuroHOPE countries, the Acute Myocardial Infarction (AMI), stroke and hip fracture patient populations were similar with regard to age, sex and comorbidity. However, non‐negligible geographic variation in mortality and resource use was found to exist. Survival rates varied to similar extents between countries and regions for AMI, stroke, hip fracture and very low birth weight. Geographic variation in length of stay differed according to type of disease. Regression analyses showed that only a small part of geographic variation could be explained by demand and supply side factors. Furthermore, the impact of these factors varied between countries. The findings show that there is room for improvement in performance at all levels of analysis and call for more in‐depth disease‐based research. In using international patient‐level data and a standardized methodology, the EuroHOPE approach provides a promising stepping‐stone for future investigations in this field. Still, more detailed patient and provider information, including outside of hospital care, and better data sharing arrangements are needed to reach a more comprehensive understanding of geographic variations in health care. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Richard Heijink & Peter Engelfriet & Clas Rehnberg & Sverre A. C. Kittelsen & Unto Häkkinen & on behalf of the EuroHOPE study group, 2015. "A Window on Geographic Variation in Health Care: Insights from EuroHOPE," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 164-177, December.
  • Handle: RePEc:wly:hlthec:v:24:y:2015:i:s2:p:164-177
    DOI: 10.1002/hec.3287
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    as
    1. Mickael Bech & Terkel Christiansen & Kelly Dunham & Jørgen Lauridsen & Carl Hampus Lyttkens & Kathryn McDonald & Alistair McGuire & and the TECH Investigators, 2009. "The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1114-1132, October.
    2. Giovanni Fatttore & Dino Numerato & Mikko Peltola & Helen Banks & Rebecca Graziani & Richard Heijink & Eelco Over & Søren Toksvig Klitkou & Eilidh Fletcher & Péter Mihalicza & Sofia Sveréus, 2015. "Variations and Determinants of Mortality and Length of Stay of Very Low Birth Weight and Very Low for Gestational Age Infants in Seven European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 65-87, December.
    3. Häkkinen, Unto & Iversen, Tor & Peltola, Mikko & Seppälä, Timo T. & Malmivaara, Antti & Belicza, Éva & Fattore, Giovanni & Numerato, Dino & Heijink, Richard & Medin, Emma & Rehnberg, Clas, 2013. "Health care performance comparison using a disease-based approach: The EuroHOPE project," Health Policy, Elsevier, vol. 112(1), pages 100-109.
    4. Moreno-Serra, Rodrigo & Wagstaff, Adam, 2010. "System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia," Journal of Health Economics, Elsevier, vol. 29(4), pages 585-602, July.
    5. Pierre‐Yves Crémieux & Pierre Ouellette & Caroline Pilon, 1999. "Health care spending as determinants of health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 627-639, November.
    6. Klim McPherson & Giorgia Gon & Maggie Scott, 2013. "International Variations in a Selected Number of Surgical Procedures," OECD Health Working Papers 61, OECD Publishing.
    7. Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
    8. Sverre A. C. Kittelsen & Kjartan S. Anthun & Fanny Goude & Ingrid M. S. Huitfeldt & Unto Häkkinen & Marie Kruse & Emma Medin & Clas Rehnberg & Hanna Rättö & on behalf of the EuroHOPE study group, 2015. "Costs and Quality at the Hospital Level in the Nordic Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 140-163, December.
    9. David Cutler & Jonathan Skinner & Ariel Dora Stern & David Wennberg, 2013. "Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending," NBER Working Papers 19320, National Bureau of Economic Research, Inc.
    10. Giovanni Fatttore & Dino Numerato & Mikko Peltola & Helen Banks & Rebecca Graziani & Richard Heijink & Eelco Over & Søren Toksvig Klitkou & Eilidh Fletcher & Péter Mihalicza & Sofia Sveréus & on behal, 2015. "Variations and Determinants of Mortality and Length of Stay of Very Low Birth Weight and Very Low for Gestational Age Infants in Seven European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 65-87, December.
    11. Mikko Peltola & Timo T. Seppälä & Antti Malmivaara & Éva Belicza & Dino Numerato & Fanny Goude & Eilidh Fletcher & Richard Heijink, 2015. "Individual and Regional‐level Factors Contributing to Variation in Length of Stay After Cerebral Infarction in Six European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 38-52, December.
    12. Emma Medin & Fanny Goude & Hans Olav Melberg & Fabrizio Tediosi & Eva Belicza & Mikko Peltola & on behalf of the EuroHOPE study group, 2015. "European Regional Differences in All‐Cause Mortality and Length of Stay for Patients with Hip Fracture," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 53-64, December.
    13. Terje P. Hagen & Unto Häkkinen & Eva Belicza & Giovanni Fatore & Fanny Goude & on behalf of the EuroHOPE study group, 2015. "Acute Myocardial Infarction, Use of Percutaneous Coronary Intervention, and Mortality: A Comparative Effectiveness Analysis Covering Seven European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 88-101, December.
    14. Sverre A. C. Kittelsen & Kjartan S. Anthun & Fanny Goude & Ingrid M. S. Huitfeldt & Unto Häkkinen & Marie Kruse & Emma Medin & Clas Rehnberg & Hanna Rättö & on behalf of the EuroHOPE study group, 2015. "Costs and Quality at the Hospital Level in the Nordic Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 140-163, December.
    15. Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
    16. Corallo, Ashley N. & Croxford, Ruth & Goodman, David C. & Bryan, Elisabeth L. & Srivastava, Divya & Stukel, Therese A., 2014. "A systematic review of medical practice variation in OECD countries," Health Policy, Elsevier, vol. 114(1), pages 5-14.
    17. Terkel Christiansen & Kelly Dunham & Jørgen Lauridsen & Carl Hampus Lyttkens & Kathryn Mcdonald & Alistair Mcguire & Carine Milcent, 2009. "The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks," Post-Print halshs-03168477, HAL.
    18. Skinner, Jonathan, 2011. "Causes and Consequences of Regional Variations in Health Care," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 45-93, Elsevier.
    19. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2.
    20. Terje P. Hagen & Unto Häkkinen & Eva Belicza & Giovanni Fatore & Fanny Goude, 2015. "Acute Myocardial Infarction, Use of Percutaneous Coronary Intervention, and Mortality: A Comparative Effectiveness Analysis Covering Seven European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 88-101, December.
    21. Oliver Reich & Cornelia Weins & Claudia Schusterschitz & Magdalena Thöni, 2012. "Exploring the disparities of regional health care expenditures in Switzerland: some empirical evidence," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 193-202, April.
    22. Asiskovitch, Sharon, 2010. "Gender and health outcomes: The impact of healthcare systems and their financing on life expectancies of women and men," Social Science & Medicine, Elsevier, vol. 70(6), pages 886-895, March.
    23. Emma Medin & Fanny Goude & Hans Olav Melberg & Fabrizio Tediosi & Eva Belicza & Mikko Peltola, 2015. "European Regional Differences in All‐Cause Mortality and Length of Stay for Patients with Hip Fracture," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 53-64, December.
    24. Mikko Peltola & Timo T. Seppälä & Antti Malmivaara & Éva Belicza & Dino Numerato & Fanny Goude & Eilidh Fletcher & Richard Heijink & on behalf of the EuroHOPE study group, 2015. "Individual and Regional‐level Factors Contributing to Variation in Length of Stay After Cerebral Infarction in Six European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 38-52, December.
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    1. Unto Häkkinen & Tor Iversen & Mikko Peltola & Clas Rehnberg & Timo T. Seppälä & on behalf of the EuroHOPE study group, 2015. "Towards Explaining International Differences in Health Care Performance: Results of the EuroHOPE Project," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 1-4, December.

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