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The hospital costs of care for stroke in nine European countries

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  • David Epstein
  • Anne Mason
  • Andrea Manca

Abstract

Stroke is a major cause of mortality and morbidity, but the reasons for differences in costs of care within and between countries are not well understood. The HealthBASKET project used a vignette methodology to compare the mean costs and prices of hospital care across providers in nine European Union countries. Data on resource use, unit costs and prices of care for female stroke patients without co‐morbidity were collected from a sample of 50 hospitals. Mean costs for each provider were analysed using multiple regression. Sensitivity analysis explored the effects on cost of using official exchange rates, purchasing power parity (PPP) and proportion of national income per capita. The mean cost of a hospital episode per patient for stroke at PPP was €3813 (standard error 227) with an additional day in hospital typically associated with 6.9% (95% CI: 4–9%) higher costs and thrombolysis associated with 41% higher costs (10–73%). After adjusting for explanatory factors, about 76% of the variation in cost could be attributed to between‐country differences, and the extent of this variation was sensitive to the method of currency conversion. There was considerable variation in the care pathways within and between countries, including differences in the availability of stroke units and access to rehabilitative services, but only the length of stay and use of thrombolytic therapy were significantly associated with higher cost. The vignette methodology appears feasible, but further research needs to consider access to healthcare over a longer follow up and to include both costs and outcomes. Copyright © 2008 John Wiley & Sons, Ltd.

Suggested Citation

  • David Epstein & Anne Mason & Andrea Manca, 2008. "The hospital costs of care for stroke in nine European countries," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 21-31, January.
  • Handle: RePEc:wly:hlthec:v:17:y:2008:i:s1:p:s21-s31
    DOI: 10.1002/hec.1329
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    File URL: https://doi.org/10.1002/hec.1329
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    References listed on IDEAS

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    1. Jonas Schreyögg & Oliver Tiemann & Tom Stargardt & Reinhard Busse, 2008. "Cross‐country comparisons of costs: the use of episode‐specific transitive purchasing power parities with standardised cost categories," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 95-103, January.
    2. Hausman, Jerry, 2015. "Specification tests in econometrics," Applied Econometrics, Publishing House "SINERGIA PRESS", vol. 38(2), pages 112-134.
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    5. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    6. Unto Häkkinen & Isabelle Joumard, 2007. "Cross-Country Analysis of Efficiency in OECD Health Care Sectors: Options for Research," OECD Economics Department Working Papers 554, OECD Publishing.
    7. Breusch, T S & Pagan, A R, 1979. "A Simple Test for Heteroscedasticity and Random Coefficient Variation," Econometrica, Econometric Society, vol. 47(5), pages 1287-1294, September.
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    Cited by:

    1. M. Pirson & L. Schenker & D. Martins & Duong Dung & J. Chalé & P. Leclercq, 2013. "What can we learn from international comparisons of costs by DRG?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 67-73, February.
    2. Raymond Oppong & Joanna Coast & Kerry Hood & Jacqui Nuttall & Richard Smith & Christopher Butler, 2011. "Resource use and costs of treating acute cough/lower respiratory tract infections in 13 European countries: results and challenges," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(4), pages 319-329, August.
    3. Jonas Schreyögg & Oliver Tiemann & Tom Stargardt & Reinhard Busse, 2008. "Cross‐country comparisons of costs: the use of episode‐specific transitive purchasing power parities with standardised cost categories," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 95-103, January.
    4. Reinhard Busse & Jonas Schreyögg & Peter C. Smith, 2008. "Variability in healthcare treatment costs amongst nine EU countries – results from the HealthBASKET project," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 1-8, January.
    5. Ellison, Brenna & Lusk, Jayson L., 2016. "Examining Household Food Waste Decisions: A Vignette Approach," 2016 Annual Meeting, July 31-August 2, Boston, Massachusetts 235609, Agricultural and Applied Economics Association.
    6. Reinhard Busse & on behalf of the EuroDRG group, 2012. "DO DIAGNOSIS‐RELATED GROUPS EXPLAIN VARIATIONS IN HOSPITAL COSTS AND LENGTH OF STAY? – ANALYSES FROM THE EURODRG PROJECT FOR 10 EPISODES OF CARE ACROSS 10 EuroPEAN COUNTRIES," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 1-5, August.
    7. Bystrov, Victor & Staszewska-Bystrova, Anna & Rutkowski, Daniel & Hermanowski, Tomasz, 2015. "Effects of DRG-based hospital payment in Poland on treatment of patients with stroke," Health Policy, Elsevier, vol. 119(8), pages 1119-1125.

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