IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Log in (now much improved!) to save this article

Examining cost variation across hospital departments-a two-stage multi-level approach using patient-level data

  • Laudicella, Mauro
  • Olsen, Kim Rose
  • Street, Andrew

Studies of hospital efficiency seldom lead to changes in practice, partly because recommendations are unspecific or results are not seen as robust. We describe a method to compare hospital costs that utilises patient-level data. We perform a two-stage analysis in which we first consider factors that explain costs among patients and then across hospital departments. We illustrate our approach by examining the costs and characteristics of almost one million patients admitted to 136 English NHS hospital obstetrics departments in 2005/2006. We identify those departments with significantly higher costs that need to take action.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(10)00602-7
Download Restriction: Full text for ScienceDirect subscribers only

As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 71 (2010)
Issue (Month): 10 (November)
Pages: 1872-1881

as
in new window

Handle: RePEc:eee:socmed:v:71:y:2010:i:10:p:1872-1881
Contact details of provider: Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description

Order Information: Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
Web: http://www.elsevier.com/orderme/journalorderform.cws_home/315/journalorderform1/orderooc/id=654&ref=654_01_ooc_1&version=01

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.:

as in new window
  1. Peter C. Smith & Andrew Street, 2005. "Measuring the efficiency of public services: the limits of analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 168(2), pages 401-417.
  2. Andrei Shleifer, 1985. "A Theory of Yardstick Competition," RAND Journal of Economics, The RAND Corporation, vol. 16(3), pages 319-327, Autumn.
  3. Bruce Hollingsworth & Andrew Street, 2006. "The market for efficiency analysis of health care organisations," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1055-1059.
  4. Nigel Rice & Andrew Jones, 1997. "Multilevel models and health economics," Health Economics, John Wiley & Sons, Ltd., vol. 6(6), pages 561-575.
  5. Wang, Hung-jen & Schmidt, Peter, 2001. "One-step and two-step estimation of the effects of exogenous variables on technical efficiency levels," MPRA Paper 31075, University Library of Munich, Germany, revised Mar 2002.
  6. Antonio Giuffrida & Hugh Gravelle, . "Measuring Performance in Primary Care: Econometric Analysis and DEA," Discussion Papers 99/36, Department of Economics, University of York.
  7. Mason, Anne & Street, Andrew & Miraldo, Marisa & Siciliani, Luigi, 2009. "Should prospective payments be differentiated for public and private healthcare providers?," Health Economics, Policy and Law, Cambridge University Press, vol. 4(04), pages 383-403, October.
  8. Hvenegaard, Anne & Street, Andrew & Sørensen, Torben Højmark & Gyrd-Hansen, Dorte, 2009. "Comparing hospital costs: What is gained by accounting for more than a case-mix index?," Social Science & Medicine, Elsevier, vol. 69(4), pages 640-647, August.
  9. Jackson, Terri, 2001. "Using computerised patient-level costing data for setting DRG weights: the Victorian (Australia) cost weight studies," Health Policy, Elsevier, vol. 56(2), pages 149-163, May.
  10. Adriana Castelli & Mauro Laudicella & Andrew Street, 2008. "Measuring NHS Output Growth," Working Papers 043cherp, Centre for Health Economics, University of York.
  11. Street, Andrew & Maynard, Alan, 2007. "Activity based financing in England: the need for continual refinement of payment by results," Health Economics, Policy and Law, Cambridge University Press, vol. 2(04), pages 419-427, October.
  12. Reinhard Busse & Jonas Schreyögg & Peter Smith, 2006. "Editorial: Hospital case payment systems in Europe," Health Care Management Science, Springer, vol. 9(3), pages 211-213, August.
  13. Daniel Bilodeau & Pierre-Yves Crémieux & Pierre Ouellette, 2000. "Hospital Cost Function In A Non-Market Health Care System," The Review of Economics and Statistics, MIT Press, vol. 82(3), pages 489-498, August.
  14. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128.
  15. Peter Smith, 1997. "Model misspecification in Data Envelopment Analysis," Annals of Operations Research, Springer, vol. 73(0), pages 233-252, October.
  16. 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.
  17. Cookson R & Laudicella M, 2009. "Do the poor still cost more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001/2 to 2006/7," Health, Econometrics and Data Group (HEDG) Working Papers 09/07, HEDG, c/o Department of Economics, University of York.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:71:y:2010:i:10:p:1872-1881. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Shamier, Wendy)

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.