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Individual and Regional‐level Factors Contributing to Variation in Length of Stay After Cerebral Infarction in Six European Countries

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Listed:
  • Mikko Peltola
  • Timo T. Seppälä
  • Antti Malmivaara
  • Éva Belicza
  • Dino Numerato
  • Fanny Goude
  • Eilidh Fletcher
  • Richard Heijink
  • on behalf of the EuroHOPE study group

Abstract

Using patient‐level data for cerebral infarction cases in 2007, gathered from Finland, Hungary, Italy, the Netherlands, Scotland and Sweden, we studied the variation in risk‐adjusted length of stay (LoS) of acute hospital care and 1‐year mortality, both within and between countries. In addition, we analysed the variance of LoS and associations of selected regional‐level factors with LoS and 1‐year mortality after cerebral infarction. The data show that LoS distributions are surprisingly different across countries and that there is significant deviation in the risk‐adjusted regional‐level LoS in all of the countries studied. We used negative binomial regression to model the individual‐level LoS, and random intercept models and ordinary least squares regression for the regional‐level analysis of risk‐adjusted LoS, variance of LoS, 1‐year risk‐adjusted mortality and crude mortality for a period of 31–365 days. The observed variations between regions and countries in both LoS and mortality were not fully explained by either patient‐level or regional‐level factors. The results indicate that there may exist potential for efficiency gains in acute hospital care of cerebral infarction and that healthcare managers could learn from best practices. Copyright © 2015 John Wiley & Sons, Ltd.

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  • 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.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:s2:p:38-52
    DOI: 10.1002/hec.3264
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    References listed on IDEAS

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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.
    2. Cunhui Wang & Niannian Li & Heng Wang & Hongyan Yin & Yunwu Zhao, 2018. "Study on essential drug use status and its influencing factors among cerebral infarction inpatients in county level hospitals of Anhui Province, China," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-12, April.
    3. 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.
    4. Christoph Pross & Christoph Strumann & Alexander Geissler & Helmut Herwartz & Nadja Klein, 2018. "Quality and resource efficiency in hospital service provision: A geoadditive stochastic frontier analysis of stroke quality of care in Germany," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-30, September.
    5. Yuxi Wang & Simone Ghislandi & Aleksandra Torbica, 2020. "Investigating the geographic disparity in quality of care: the case of hospital readmission after acute myocardial infarction in Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1149-1168, November.
    6. 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.

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