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Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007

Author

Listed:
  • Corinna Hentschker
  • Roman Mennicken

    (FOM University of Applied Sciences, Essen Landschaftsverband Rheinland)

  • Antonius Reifferscheid

    (University Duisburg-Essen)

  • Jürgen Wasem

    (University Duisburg-Essen)

  • Ansgar Wübker

    (RWI, RUB and Leibniz Science Campus Ruhr)

Abstract

Background This paper analyses the volume-outcome relationship and the effects of minimum volume regulations in the German hospital sector. Methods We use a full sample of administrative data from the unselected, complete German hospital population for the years 2005 to 2007. We apply regression methods to analyze the association between volume and hospital quality. We measure hospital quality with a binary variable, which indicates whether the patient has died in hospital. Using simulation techniques we examine the impact of the minimum volume regulations on the accessibility of hospital services. Results We find a highly significant negative relationship between case volume and mortality for complex interventions at the pancreas and oesophagus as well as for knee replacement. For liver, kidney and stem cell transplantation as well as for CABG we could not find a strong association between volume and quality. Access to hospital care is only moderately affected by minimum volume regulations. Conclusion The effectiveness of minimum volume regulations depends on the type of intervention. Depending on the type of intervention, quality gains can be expected at the cost of slightly decreased access to care.

Suggested Citation

  • Corinna Hentschker & Roman Mennicken & Antonius Reifferscheid & Jürgen Wasem & Ansgar Wübker, 2018. "Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007," Health Economics Review, Springer, vol. 8(1), pages 1-14, December.
    • Handle: RePEc:spr:hecrev:v:8:y:2018:i:1:d:10.1186_s13561-018-0204-8
    DOI: 10.1186/s13561-018-0204-8
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    References listed on IDEAS

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    1. Mesman, Roos & Faber, Marjan J. & Berden, Bart J.J.M. & Westert, Gert P., 2017. "Evaluation of minimum volume standards for surgery in the Netherlands (2003–2017): A successful policy?," Health Policy, Elsevier, vol. 121(12), pages 1263-1273.
    2. Carine Milcent, 2005. "Hospital ownership, reimbursement systems and mortality rates," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1151-1168, November.
    3. Corinna Hentschker & Roman Mennicken, 2015. "The Volume‐Outcome Relationship and Minimum Volume Standards – Empirical Evidence for Germany," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 644-658, June.
    4. David Barker & Gary Rosenthal & Peter Cram, 2011. "Simultaneous relationships between procedure volume and mortality: do they bias studies of mortality at specialty hospitals?," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 505-518, May.
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    Cited by:

    1. Kaiser, Florian & Schmid, Andreas & Schlüchtermann, Jörg, 2020. "Physician-leaders and hospital performance revisited," Social Science & Medicine, Elsevier, vol. 249(C).
    2. Justus F. A. Vogel & Max Barkhausen & Christoph M. Pross & Alexander Geissler, 2022. "Defining minimum volume thresholds to increase quality of care: a new patient-oriented approach using mixed integer programming," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1085-1104, September.
    3. Huguet, Marius, 2020. "Centralization of care in high volume hospitals and inequalities in access to care," Social Science & Medicine, Elsevier, vol. 260(C).

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    More about this item

    Keywords

    Volume; Hospital quality; Mortality; Access to care;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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