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Differences in general practice initiated expenditures across Danish local health authorities--A multilevel analysis

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  • Sørensen, Torben H.
  • Olsen, Kim R.
  • Gyrd-Hansen, Dorte

Abstract

Objective To assess differences in expenditures of general practice services across local health authorities (counties).Methods A multilevel analysis of 2123 general practices nested within 15 counties is used to assess between county variations in general practice expenditures in year 2006. Schmidt and Sickles' fixed effect efficiency estimator is used to assess the potential for reducing expenditures (fee-for-service, prescriptions, and referrals).Results Expenditures associated with general practice constitute 38% of total health care expenditures. 42% of the variation in these expenditures is attributable to geographical location (county). Mean efficiency is estimated to 87% corresponding to a savings potential of 700 DKK per insured person. Referrals to specialised care are the main source of variation in GP initiated expenditures across the counties. Expenditures associated with out-patient referrals and referrals to practicing specialist are negatively correlated (pÂ

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  • Sørensen, Torben H. & Olsen, Kim R. & Gyrd-Hansen, Dorte, 2009. "Differences in general practice initiated expenditures across Danish local health authorities--A multilevel analysis," Health Policy, Elsevier, vol. 92(1), pages 35-42, September.
    • Handle: RePEc:eee:hepoli:v:92:y:2009:i:1:p:35-42
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    1. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July.
    2. Anni Ankjær-Jensen & Pernille Rosling & Lone Bilde, 2006. "Variable prospective financing in the Danish hospital sector and the development of a Danish case-mix system," Health Care Management Science, Springer, vol. 9(3), pages 259-268, August.
    3. Jaume Puig‐Junoy & Vicente Ortún, 2004. "Cost efficiency in primary care contracting: a stochastic frontier cost function approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(12), pages 1149-1165, December.
    4. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442.
    5. Schmidt, Peter & Sickles, Robin C, 1984. "Production Frontiers and Panel Data," Journal of Business & Economic Statistics, American Statistical Association, vol. 2(4), pages 367-374, October.
    6. Antonio Giuffrida & Hugh Gravelle, 2001. "Measuring performance in primary care: econometric analysis and DEA," Applied Economics, Taylor & Francis Journals, vol. 33(2), pages 163-175.
    7. Kim Rose Olsen & Andrew Street, 2008. "The analysis of efficiency among a small number of organisations: How inferences can be improved by exploiting patient‐level data," Health Economics, John Wiley & Sons, Ltd., vol. 17(6), pages 671-681, June.
    8. Matthias Staat, 2003. "The efficiency of treatment strategies of general practitioners," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 232-238, September.
    9. Gaynor, Martin & Pauly, Mark V, 1990. "Compensation and Productive Efficiency of Partnerships: Evidence from Medical Group Practice," Journal of Political Economy, University of Chicago Press, vol. 98(3), pages 544-573, June.
    10. Lisa C. DeFelice & W. David Bradford, 1997. "Relative inefficiencies in production between solo and group practice physicians," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 455-465, September.
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    2. Elena Cottini & Claudio Lucifora & Gilberto Turati & Daria Vigani, 2020. "Children Use of Emergency Care: Differences Between Natives and Migrants in Italy," DISCE - Working Papers del Dipartimento di Economia e Finanza def093, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    3. Yan Meng & Xueyan Zhao & Xibin Zhang & Jiti Gao, 2017. "A panel data analysis of hospital variations in length of stay for hip replacements: Private versus public," Monash Econometrics and Business Statistics Working Papers 20/17, Monash University, Department of Econometrics and Business Statistics.
    4. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2012. "Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust," European Journal of Operational Research, Elsevier, vol. 221(2), pages 432-444.
    5. Thanassoulis, Emmanuel & Silva Portela, Maria & Graveney, Mike, 2016. "Identifying the scope for savings at inpatient episode level: An illustration applying DEA to chronic obstructive pulmonary disease," European Journal of Operational Research, Elsevier, vol. 255(2), pages 570-582.

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