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Demand in New Zealand hospitals: expect the unexpected?

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  • Nan Jiang
  • Gail Pacheco

Abstract

The health care sector in New Zealand has undergone substantial structural reform since 1983 and stands out relative to other OECD countries, with relatively low per capita health expenditure and a high share of public funding. Efficient allocation of resources in this public dominant health system is therefore paramount. This article uses a national database of hospital admissions to predict hospital demand. We find lagged information on patient demand imperative in formulating an easy to implement approach for predictive purposes. Contrasting predicted with actual demand, we construct an indicator of volatility in unexpected patient demand (at both the hospital and the disease chapter level) and assess its role with regard to patient outcomes. There is consistent evidence that when actual patient numbers exceed predicted, patients stay in hospital significantly longer and are more likely to have an acute readmission.

Suggested Citation

  • Nan Jiang & Gail Pacheco, 2014. "Demand in New Zealand hospitals: expect the unexpected?," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4475-4489, December.
  • Handle: RePEc:taf:applec:v:46:y:2014:i:36:p:4475-4489
    DOI: 10.1080/00036846.2014.964830
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    References listed on IDEAS

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    1. Laudicella, Mauro & Li Donni, Paolo & Smith, Peter C., 2013. "Hospital readmission rates: Signal of failure or success?," Journal of Health Economics, Elsevier, vol. 32(5), pages 909-921.
    2. Christoph Schwierz & Boris Augurzky & Axel Focke & Jürgen Wasem, 2012. "Demand, selection and patient outcomes in German acute care hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 209-221, March.
    3. Cook, Andrew & Gaynor, Martin & Stephens Jr, Melvin & Taylor, Lowell, 2012. "The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation," Journal of Health Economics, Elsevier, vol. 31(2), pages 340-348.
    4. Evans, William N. & Kim, Beomsoo, 2006. "Patient outcomes when hospitals experience a surge in admissions," Journal of Health Economics, Elsevier, vol. 25(2), pages 365-388, March.
    5. Monica Oliveira, 2004. "Modelling demand and supply influences on utilization: A flow demand model to predict hospital utilization at the small area level," Applied Economics, Taylor & Francis Journals, vol. 36(20), pages 2237-2251.
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